gms | German Medical Science

Objective: Isolated hand injuries are common in the emergency and orthopaedic departments. Neglecting potential additional pain complaints in the upper limb and neck may hamper rehabilitation and prolong time to return to daily and work-related activities. The purpose of this study was to investigate the prevalence of additional pain complaints in the elbow, shoulder, and neck after an isolated hand injury.

Materials and Methods: This cross-sectional study included 600 consecutive patients that were seen during the course of 18 months in a single department of hand-rehabilitation. We included patients with any type of diagnosis referred to rehabilitation following an isolated hand injury. At first contact, we used a self-report questionnaire to examine the prevalence of pain in the elbow, shoulder, and neck before and after their isolated hand injury. Baseline characteristics and a diagnosis of hand injury were collected from the medical records.

Results: Among the 600 included patients, the largest diagnostic groups were distal radius and ulna fractures (24.5%), ligament lesions and ruptures in fingers (15.5%), and finger fractures (13.5%). The mean age was 49.1 (range 6-90) years, with 57% women. The overall prevalence of additional pain complaints was 40%. 27.5% of the whole sample developed additional pain complaints after their isolated hand injury and 12.5% reported pain complaints before the hand injury. In women the prevalence of additional pain complaints was 67.6% and 32.4% in men. The most common pain location was shoulder (62.6%), followed by elbow (49.3%), and neck (32.3%). 38% of patients had additional pain complaints in two or three regions of the upper limb and neck.

Conclusions: Clinicians treating patients with isolated hand injuries should be aware of the high prevalence of additional pain complaints in the elbow, shoulder, and neck after an isolated hand injury. Future research should investigate if this population requires additional rehabilitation.