الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
• Hand trauma is a hidden epidemic with dominance of male gender and age between 20-40 yrs. The most common cause was occupational, followed by domestic causes among females children and patients with high education, followed by violence and lastly RTA. Hand injury can be associated with previous injury to the same hand. Most patients have no past medical history. • Questionnaires about substance abuse is unreliable due to patient biases and influenced by fear, insecurity, and the potential legal implications. • The highest peak of incidence was between June and September, and about 1/3 of injuries occurred between 8:00 PM and 8:00 AM, and the number of cases received are inversely proportionate to their distance from Tanta University Hospitals and may not reflect the actual incidence of hand trauma among these areas as central hospitals are expected to manage many hand trauma patients. • The preschool, school, and university students are covered by National Health insurance, which can reduce the financial burden of rehabilitation. • About 1/3 of hand trauma cases were severe (involving bone), mainly due to occupational causes and RTA. • A considerable portion of hand trauma patients needed microsurgical techniques. Conclusion and Recommendation • Non dominant hand injury is mostly left hand and dominant hand injury is mostly right hand. • Craft related hand injury represent the majority of all occupational hand injuries. The peak incidence was observed in June, august, May and November. There is almost no documented female injuries in work related hand injury. More than half of cases aged 19-40 yrs. PPE were absent in most cases and PPE was present but not applied in 25.6% cases. The injuries were mainly caused by the angle grinder and by the table saw. • Hand injuries related to agriculture represent 22% of all occupational hand injury. Which is more common in males. The most common age of injury is 20-40 yrs. September showed the highest incidence which correspond to harvest season. There’s striking negligence of safety precautions was significant since PPE were almost always absent in agricultural trauma. Simple tools (e.g. Sickle) caused injury more than heavy agricultural machinery (e.g. threshing machine). • Most hand trauma patients had an experience of at least one year at the time of trauma. But there is a significant deficiency in abundance and application of protective equipment. Only ¼ of hand trauma is associated with other body injuries While patients with previous injury to the same hand mainly sustain severe injury. • Occupational hand injury was surprisingly a very common cause of hand trauma between 6 and 18 years of age (1/5 of all hand trauma) which is definitely against national laws and regulations and usually occur behind the back of authorities. Conclusion and Recommendation • Illiteracy is not a major factor contributing to hand injury, including trauma in work related environment. Recommendation: ➢ So, we recommend promoting health education programs and campaigns to increase awareness about the crisis of hand Injury. ➢ Opening routes for national or private health insurance would ameliorate the impact of trauma and help patients to avoid permanent disability or not returning to the same job. ➢ Providers of healthcare should be well prepared before these months to deal adequately with this expected high rate of cases. ➢ Providers of healthcare should either schedule the night complicated cases to the next day operative list if ischemia is excluded or to arrange night shift teams qualified and trained and prepared for dealing with these emergency cases. ➢ It is important to apply and frequently update regulations in work environments especially workshops and farms regarding the use of certain tools and machinery as angle grinder threshing and silage chopper machines and especially in the beginning of High-risk season. ➢ We recommend a national scale audit to ensure applying the law in facing child labor. ➢ we recommend Enforcing training programs in technical institutions addressing trainees since they construct the major population of hand trauma patients. We also recommend carrying out regular health checks for workers with comorbidities and regularly assessing their capacity and capability to continue working without risk of injury. Conclusion and Recommendation Prevention mandates continuous supply with personal protective equipment and continuous training for its use for target population of workers. ➢ Media and movies definitely play an important role the infestation of violence in the community and thus it’s important to raise the authorities watch over the media industry. ➢ efforts to raise maternal awareness and to focus on maternal education for providing safer home environment. ➢ Hand injury should be focused upon while passing laws and legislation and while providing funding since its considered a hidden epidemic, that is usually underestimated.