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An alternative classification of occupational hand injuries based on etiologic mechanisms the ECOHI classification

BACKGROUND
The aim of this study was to construct an alternative classification
system for occupational hand injuries based on
etiologic mechanisms and to analyze the injury patterns resulting
from various mechanisms.
METHODS
A retrospective analysis of patients operated between January
2005 and December 2007 in two hand surgery units staffed
by a team of hand surgeons was made. The patient files were
retrospectively examined, and mechanisms causing the injuries
were analyzed. Similar mechanisms were classified in the
same groups, and the mechanism of injury was matched with
type of injury often caused by this mechanism. In the classification
of injuries, the tissues that were injured were taken as
a basis for classification. 4120 upper extremity injuries were
seen in the study hospitals, and 2188 (53.1%) of them were occupational
injuries. There were 2063 males (94.3%) and 125
females (6.7%). The mean age was 28.2 (range: 15-71) years.
RESULTS
Examination of the agents causing injury yielded 62 agents.
Further examination of these agents showed that the mechanism
by which they caused injury was similar in some
agents, and these agents were placed in the same groups,
which constituted the Etiologic Classification of Hand Injuries
(ECOHI) classification. These groups of mechanisms
were: cutting-penetrating, cutting-crushing, crushing-penetrating,
crushing-compressing, crushing-burning, stinging,
avulsing, electrical current, and chemical injuries and miscellaneous
burns. The two most common mechanisms were
crushing-compressing and cutting-crushing types, constituting

744 (34.0%) and 514 (23.5%) of injuries, respectively.