A Proposed Classification for Sugarcane Crusher Injuries of the Hand and Its Correlation with Patient Rated Outcome Scores at 6 Months

Abstract

Background: Crush injuries of the hand sustained from sugarcane juice extracting machines have a unique mechanism of injury and clinical presentation. The severity of the injury can vary from simple skin lacerations to mangling of the hand. We devised a classification for these injuries based on the severity level that has helped with the management. The aim of this study is to determine whether the classification correlates with patient rated outcome score at 6 months. Methods: We prospectively studied 30 consecutive patients with a sugarcane crusher injury of the hand. The patients were classified into Class I, II, III or IV based on our classification and managed accordingly. Patient outcomes were assessed at 6 months after the injury, using the Michigan Hand Outcomes Questionnaire (MHQ). Spearman’s rank correlation test was used to analyse the correlation between the different classes of hand injury and functional outcomes at 6 months following injury (measured using MHQ). Results: The study included 6 patients (20%) with Class I injury, 11 patients (36.6%) with Class II, 9 patients (30%) with Class III and 4 patients (13.4%) with Class IV injury. The mean MHQ scores at 6-month follow-up were 72.3% in Class I, 62.1% in Class II, 52.9% in Class III and 32% in Class IV injuries. An inversely proportional association between the severity grade as per the classification and MHQ scores was noted. Conclusion: Our proposed classification of sugarcane crusher injuries of the hand correlates well with the MHQ score. The use of the classification can help with management and predicting prognosis. In addition, wider use will permit comparison of outcomes between different centres. Level of Evidence: Level IV (Therapeutic)

Effect and Mechanism of Dragon’s Blood on Wound Healing of Patients with Stress Hand Injury

“…Granulation tissue is difficult to form for a long time, and the self-repair function of the body is affected, which means it cannot meet the conditions needed for wound recovery. On the other hand, stress wounds are prone to ischemia and hypoxia, and matrix metalloproteinases are constantly activated, which will cause the decomposition of cell growth factors and affect the growth and proliferation of epidermal cells, making wound recovery difficult [ 11 ]. Western medicine usually adopts debridement treatment, surgical intervention, electrical stimulation, biotechnology, and negative pressure wound therapy to carry out wound recovery treatment [ 12 ].…”