dominant hand being expected to be 10% stronger than
the left non-dominant hand, whereas the left dominant
hand was expected to be as strong as the right nondominant
hand). Due to lack of evidence, this 10% rule
was not applied during our between-side comparison.
The validity of alternative comparisons between clinically
obtained measurements and normative values is
limited as they are legitimate only as long as the
employed test methods closely resemble those used to
obtain the normative values [25].
Prevention is far better than trying to deal with the
aftermath of an injury. A recently published study on
the trauma mechanisms due to circular power saws
revealed the so-called kickback-mechanism as the leading
cause of injury [11]. When cutting, ripping or otherwise
shaping boards on table-mounted rotary saws, a
kickback of the piece occurs when the saw blade
becomes hung in the board whereupon the board is
rapidly propelled backward into the operator. This
causes the stock to bounce out and hit the operator’s
hand as he tries to stop the stock from flying up and
causes his hand to contact the blade. This injury
mechanism accounts for roughly 90% of blade contact
injuries [1,11]. Various devices and methods have been
developed to try to alleviate the problem of stock kickback
or to avoid blade contact [1]. However, non-professional
wood cutters mainly use non-professional power
tools, particularly the smaller and cheaper “consumer
models” which regularly lack safety-equipment, such as
anti-kickback devices or blade contact avoidance
systems.
With regard to personal protective equipment (PPE),
hearing protection against noise at high decibel levels
and/or exposure periods, safety glasses and face shields
against airborne debris or stock kicked-back are strongly
recommended. However, there is general agreement that
working gloves should never be worn around reciprocating
or rotating machine parts, e.g. power saws.
Limitations of the study
This study has several limitations, the foremost of which
is its retrospective nature.
This investigation does not describe the whole number
of circular saw-related hand injuries as it encompasses
only hospitalized patients and no patients that were discharged
after emergency room treatment. However, the
number of patients suffering circular saw injuries that
were treated and released in our trauma unit is very
small compared to the number of hospitalized patients.
The outcome data in this study is somewhat limited, as
one third of the casualties were lost for clinical followup
assessment. We still believe, however, that our series
is a reasonably representative sample of the patients’
personal and the nation’s socio-economic burden resulting
from this common injury pattern.
Conclusion
Everyday occurrence of circular saw related hand injuries
accompanied by well established treatment algorithms
and relatively short periods of in-house
treatment might distort the real dimension of the
patients’ remaining disability and impairment.
While the trauma surgeon’s view is generally confined
to the patients’ clinical course, the outcome parameters
in this follow-up investigation (with loss of working
time as key factor) confirm that the whole socioeconomic
burden is much greater than the direct costs of
treatment.