BackgroundTo study costs and outcome for serious hand and arm injuries during the first year after the trauma.MethodsIn patients with a Hand Injury Severity Score (HISS) > 50, DASH and EQ-5D scores as well as factors related to costs within the health care sector, costs due to lost production and total costs were evaluated. Cox-regression analysis stratifying for mechanism of injury was used to analyse return to work.ResultsThe majority of the 45 included patients (median 42 years 16–64) were men with severe (n = 9) or major (n = 36) injuries with different type of injuries (amputations n = 13; complex injuries n = 18; major nerve injuries/full house n = 13; burn injury n = 1). DASH and EQ-5D decreased and increased, respectively, significantly over time during one year. Total costs (+34%) and costs of lost production were highest for persons injured at work. Factors associated with higher health care costs were age >50 years (+52%), injury at work (+40%) and partial labour market activity (+66%). Costs of lost production had a significant role in total costs of injury. Patients with major injuries had longer duration of sick leave. Patients with severe injuries were more likely to return to work [(RR 3.76 (95% CI 1.38-10.22) from Cox regression, controlling for age, gender and presence of nerve injury].ConclusionsDespite the fact that work environments have constantly improved over the last decades, we found that hand injuries at work were most costly both in terms of health care and costs of lost production, although the severity, i.e. HISS, did not differ from injuries occurring at home or during leisure.

BackgroundOur objective was to explore outcome and clinical changes in hand function, satisfaction in daily occupations, sleep disturbances, health and quality of life in consecutive patients after a severe or major hand injury. Our objective was also to investigate possible differences between groups according to severity of injury, presence of peripheral nerve injury and the patients' sense of coherence.MethodsA postal questionnaire, including demographic data, disabilities of the arm, shoulder and hand (DASH), QoL (SF-36), EuroQol (EQ-5D VAS), hand function (VAS), satisfaction in daily occupation (SDO), was sent out 3, 6 and 12 months after injury to 45 consecutive patients with a severe or major hand injury. Sense of coherence (SOC) was evaluated at 6 months. For the descriptive study, non-parametric tests were used since almost all results were measured with ordinal scales, the study sample was small, and most variables not normally distributed.ResultsAlmost all self-assessed aspects of hand function, satisfaction in daily occupations, health (DASH), and physical QoL (SF-36) improved statistically for the whole group over time. Large clinical improvement was seen for physical QoL and health, while a low or no improvement was observed for mental QoL, and cold sensitivity. Few differences were found between participants with a severe or major of hand injury or with or without a major nerve injury. No significant differences in demographic data were observed between participants with high or low SOC, but participants with low SOC showed significantly lower satisfaction in daily occupations, higher DASH scores, lower mental QoL, more sleep disturbances, and bodily pain. Correlation was found between SOC, and QoL, health and satisfaction in daily occupations.ConclusionsSOC had a significant influence on patients with a severe or major traumatic hand injury. Patients with lower SOC would probably benefit from extra support and help to master their daily life, indicating that sense of coherence is an indicator for future rehabilitation focus.

Fitness training and its effect on musculoskeletal pain in professional ballet dancers Ramel E, Thorsson D, Wollmer l? Fitness training and its effect on musculoskeletal pain in professional ballet dancers.

The prevalence of injury is high in professional dancers with a significant percentage not reporting their injuries for a variety of reasons. Number of years dancing and rank are associated with injury in professional ballet dancers.