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Predictive value of psychological screening in acute hand injuries. J Hand Surg Am 1992 Mar;17(2):196-9



Pubmed ID




Scopus ID

2-s2.0-0026545552   28 Citations


Difficulties in adjustment frequently accompany severe hand injuries. The purpose of this study was to determine whether presurgical screening could predict long-term adjustment problems. One hundred thirteen patients with severe hand injuries completed a presurgical questionnaire evaluating flashbacks, avoidance, and causal factors pertaining to the injury. Patients were evaluated by a psychologist within 5 days after surgery and again 6 months later. Flashbacks initially occurred with equal frequency in occupationally and nonoccupationally injured groups. At 6-month follow-up 50% of the occupationally injured patients and 25% of the nonoccupationally injured patients had flashbacks. Avoidance of the activity at which patients were injured was also assessed. Among occupationally injured patients, 52% initially reported no avoidance compared with 17% at follow-up. Patients with nonoccupational injuries showed more initial avoidance (68%), with slightly less at follow-up (61%). Of the occupationally injured patients, 46% initially reported personal error or fatigue as the cause of their injury, but only 6% reported this as the cause at follow-up; it is interesting that at 6-month follow-up 81% of this group reported machine failure or lack of safeguards. Among nonoccupationally injured patients, 71% reported personal error as the cause of injury presurgically and 66% at 6-month follow-up. Presurgical screening appears to be a valid means of identifying persons at risk of ongoing adjustment problems after hand injury. A screening interview can easily be conducted in less than 5 minutes.

Author List

Grunert BK, Hargarten SW, Matloub HS, Sanger JR, Hanel DP, Yousif NJ


Brad K. Grunert PhD Professor in the Plastic Surgery department at Medical College of Wisconsin
Stephen W. Hargarten MD, MPH Associate Dean, Director, Professor in the Emergency Medicine department at Medical College of Wisconsin
Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Accidents, Occupational
Acute Disease
Avoidance Learning
Follow-Up Studies
Hand Injuries
Predictive Value of Tests
Preoperative Care