OBJECTIVE: To examine the loss of earning capacity and permanent impairment of a cohort of male patients who had experienced finger amputation due to occupational injury. DESIGN: Prospective cohort study. SETTING: University teaching hospital, Hong Kong. PATIENTS: Twenty-eight male patients aged 26 to 55 years who presented with work-related finger amputations in their dominant right hand from 1990 through 1991. MAIN OUTCOME MEASURES: Type and extent of amputation, and hand function before and after (mean, 11 months; range, 8-6 months) the patients' return to work. Assessment results were compared with patients' percentage loss of earning capacity as calculated using the scale described in the Employees' Compensation Ordinance of Hong Kong. RESULTS: Patients with injuries that corresponded to a loss of earning capacity of 12% or greater had a significant impairment in their hand function (P<0.05); the hand function of this group after their return to work significantly improved (P<0.05). There were no significant differences between the loss of earning capacity scores as calculated by the Hong Kong, American Medical Association, or Indian Medical Association scales. CONCLUSION: Patients whose loss of earning capacity of 12% or greater are likely to have significant long-term impairments of hand function. Thus, a more intensive rehabilitation programme should be provided to this group.