AB080. SOH24AB_212. The MISHAP trial: managing injuries—A study of hand appearance and psychosocial dysfunction

Background: Over 24 million hand injuries occur globally every year. Patients suffer chronic pain, functional impairment and loss of income, causing significant psychological distress. The aim of this study was to investigate the functional and psychosocial impact of hand injuries and their association with injury severity. Methods: A single-centre, prospective, observational study was conducted over a six-month period in St. Vincent's University Hospital. Patients with traumatic hand injuries were assessed for inclusion. Patient-reported outcome measures were collected at two and six weeks postoperatively using the Disabilities of the Arm, Shoulder and Hand (DASH) scale, Derriford Appearance Scale-24 (DAS-24), Conor-Davidson Resilience Scale-25 (CD-RISC-25), Post Traumatic Growth Inventory-Short Form (PTGI-SF), Hospital Anxiety and Depression Scale (HADS) and Short Form-36 (SF-36). The hand injury severity score (HISS) and demographic data were obtained from medical records. Paired samples t-test and correlation analyses were performed to analyse data. Results: Data were collected from 62 patients at baseline and 44 (71%) at follow-up. The mean age was 44 years (range: 20–72 years) with a male preponderance (89%). The mean HISS was 38 (range: 2–204), with 21% scoring severe injuries. HADS, DASH, SF-36 and CD-RISC-25 scores were less favourable than the general population mean. Ten and fourteen percent of participants had above-average DAS-24 scores at baseline and follow-up, respectively. HADS, DASH and SF-36 scores significantly improved at follow-up. Scores were not significantly correlated with HISS. Conclusions: Our patient cohort demonstrated higher-than-average psychological distress and functional disability, irrespective of injury severity, highlighting the need for psychological input in the multidisciplinary management of hand trauma.