Back to 2026 Abstracts
Hazard at Hand: Nationwide Patterns of Occupational Hand and Finger Amputations and Implications for Prevention
Kaan T. Oral, BA
1, Katherine G. Stark, BS
1, Daniel Y. Kwon, BS
1, Henry Diamond-Pott, BA
1, Diana S. Shaari, BA
1, Sheuli Chowdhury, MD
1,2, Peter J. Taub, MD, MS, FACS
1; Peter W. Henderson, MD, MBA, FACS
1(1)Icahn School of Medicine at Mount Sinai, New York, NY, (2)University of Vermont Medical Center, Burlington, VT
Introduction: Traumatic hand and finger amputations pose serious occupational health and socioeconomic challenges with the potential for lifelong disability. However, large-scale data on the demographics, injury patterns, and healthcare resource utilization for work-related hand and finger amputations are limited. This study aims to define the national burden of these injuries to inform prevention strategies and support efficient allocation of healthcare resources.
Materials and Methods: A database retrospective cohort study was conducted using the Healthcare Cost and Utilization Project-National Inpatient Sample (HCUP-NIS) from 2018-2022. Discharge information was obtained for patients who fulfilled ICD-10-CM diagnosis code criteria for traumatic hand or finger amputations. Patients were stratified by ICD-10-CM codes defining occupational injuries. Variables included demographics (age, sex, insurance status, income quartile by ZIP code, region), amputation characteristics (finger vs. hand, proximal vs. distal, complete vs. partial, multiple digits), injury mechanisms and locations, and patient outcomes (replantation rates, length of stay, charges, in-hospital mortality).
Results: Of 24,690 total admissions for traumatic hand or finger amputations, 11.0% (n = 2,725) were work-related. The relative proportion of occupational amputations increased between 2018-2022 (11.72% in 2022 vs. 9.91% in 2018; p < 0.001) and varied significantly across census divisions (p < 0.001). Work-related cases had a younger median age (41 vs. 44 years; p < 0.001), narrower age distribution (IQR: 22 vs. 31 years), were significantly more likely to involve males (91.2% vs. 83.5%; p < 0.001), less likely to occur on weekends (15% vs. 28.5%; p < 0.001), and predominantly affected patients from lower-income ZIP codes (p = 0.023). Among occupational cases, injuries caused by heavy machinery and occurring in construction sites or factories were significantly overrepresented (p < 0.001).
Compared to non-occupational amputations, occupational cases had greater replantation rates, shorter hospital stays, lower total healthcare costs, and decreased mortality (all p < 0.001). Interestingly, occupational amputations were more likely to involve multiple digits (36% vs. 30%; p < 0.001) and result in complete proximal wrist amputations (18% vs. 11%; p = 0.03) than non-occupational cases.
Conclusions: Occupational accidents comprise over 10% of traumatic hand and finger amputations and have distinct demographic, socioeconomic, and mechanistic patterns, disproportionately affecting working-age males coming from lower-income ZIP codes and working in high-risk industries like construction. These findings underscore the need for targeted workplace safety interventions, educational initiatives, and equitable access to specialized care to reduce the burden of these injuries in this population.
Back to 2026 Abstracts
