Accidental circular saw hand injuries: Trauma mechanisms, injury patterns, and accident insurance

Frank, Matthias; Lange, Joern; Napp, Matthias; Hecht, Juliane; Ekkernkamp, Axel; Hinz, Peter

doi:10.1016/j.forsciint.2010.01.003

« Previous Next »Forensic Science International
Volume 198, Issue 1 , Pages 74-78, 20 May 2010

Accidental circular saw hand injuries: Trauma mechanisms, injury patterns, and accident insurance

Matthias Frank
- Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University Greifswald, Germany
- Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Germany
- Corresponding author at: Department of Trauma and Orthopedic Surgery, Ernst-Moritz-Arndt-University Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany. Tel.: +49 3834 86 22 541.
Joern Lange
- Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University Greifswald, Germany
Matthias Napp
- Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University Greifswald, Germany
Juliane Hecht
- Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University Greifswald, Germany
Axel Ekkernkamp
- Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University Greifswald, Germany
- Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Germany
Peter Hinz
- Department of Trauma and Orthopedic Surgery, Emergency Department, Ernst-Moritz-Arndt-University Greifswald, Germany

Received 1 August 2009; received in revised form 14 October 2009; accepted 7 January 2010. published online 29 January 2010.

Abstract

Introduction

Hand injuries due to circular saws are a common reason for patients seeking medical care in emergency departments. With respect to cases of insurance fraud, these injuries are of medico-legal interest. It is the aim of this study to investigate the critical circumstances of the incidents, the accident mechanism, and the specific injury patterns of circular saw related hand injuries with regard to accident insurance coverage.

Patients and methods

Circular saw related hand injuries for the years 1999 through 2007 were followed-up and assessed in detail. Type, severity and pattern of the injury were assessed. An accident analysis investigated characteristic of the activities, of the saws, of the stock/cutting material, operational activities of the operators prior to/at the time of the incident, and detailed information on the insurance status.

Results

The follow-up study encompassed 114 patients. A majority of these were covered by private or statutory accident insurances. Compensation payments were made in all cases. All lesions involved one hand, mainly the left non-dominant hand. Thumb and index were at highest risk for injury. One-finger injuries occurred mainly at the middle or distal phalanx. With increasing number of affected fingers, the level of the injury moved closer to the proximal phalanx. A majority of injuries occurred during do-it-yourself activities. Among blade contact injuries, the so-called kickback-mechanism was at highest risk.

Conclusion

Positive circumstantial indications of a self-inflicted injury, which are often cited in the literature are less conclusive for the medico-legal decision finding. The detailed anatomic description of any lesions and the alleged accident mechanism as initially described by the patients in the emergency setting is the basis for any later accident reconstruction.

Keywords: Trauma mechanics, Accident analysis, Hand injury, Power tool, Tool mark, Circular saw