Clinical Sciences/Health Conditions
Chen Yu Chen, MS
Supervisor of Physical Therapy
Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan / Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Tainan, Tainan, Taiwan (Republic of China)
Shu Yu Yang, MS
Occupational Therapist
Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan
Tainan, Tainan, Taiwan (Republic of China)
Chung Han Ho, PhD
Associate Research Fellow
Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
Tainan, Tainan, Taiwan (Republic of China)
Pei Chi Hsiao, MD
Visiting Staff
Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan
Tainan, Tainan, Taiwan (Republic of China)
Yi Ju Tsai, PhD
Professor
Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Tainan, Tainan, Taiwan (Republic of China)
Hand crush injuries are complex traumas that often lead to prolonged immobilization, causing functional limitations and severe upper limb complications, including shoulder stiffness or adhesive capsulitis. The relevance of hand crush injuries and shoulder pathologies remains underexplored in clinical literature. Understanding this correlation may provide evidence for early rehabilitation strategies to prevent secondary shoulder complications. This study aimed to investigate the effect of early rehabilitation on the development of shoulder problems following hand crush injuries.
Design:
Data were collected from the Longitudinal Generation Tracking Database (LGTD 2005) of the Health and Welfare Data Science Center (HWDC) of Taiwan to identify patients with hand crush injuries. After excluding patients under 20 years of age and those with a prior shoulder crush injury before the hand crush injury diagnosis, a total of 42,475 patients with hand crush injuries were included in the study and were divided into rehabilitation (n=15,154) and non-rehabilitation (n=27,321) groups. Analysis was then conducted to compare the incidence of shoulder problems (frozen shoulder, stiffness, impingement, or related disorders) within 3 months, 6 months, and 1 year post-injury.
Results:
Rehabilitation significantly reduced the risk of developing shoulder problems within 3 months (AHR=5.37, p< 0.0001), 6 months (AHR=3.61, p< 0.0001), and 1 year (AHR=3.15, p< 0.0001). Age and female gender were associated with higher risks, while hyperlipidemia was the only comorbidity independently linked to increased shoulder problem incidence. Combined injuries showed no significant association.
Conclusion:
This study demonstrates that early rehabilitation significantly mitigates the risk of shoulder complications in patients with hand crush injuries. Age, gender, and hyperlipidemia are critical predictive factors that should be considered for risk stratification and planning individualized rehabilitation programs. Therefore, in clinical practice, early intervention not only improves shoulder mobility but also enables timely detection and management of emerging shoulder problems.
