Trends of hand injuries presenting to US emergency departments: A 10-year national analysis

Background: The purpose was to observe current incidence and trends of hand and wrist injuries presenting to U.S. emergency departments (EDs) over a decade.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for hand and wrist injuries from January 2009-December 2018. Descriptive analyses were used to report injury types to the hand and wrist. Incidence, age, gender, race, injury location, and type of injury were recorded. Linear regression analyses were used to assess changes in trends over time. A p value <0.05 was statistically significant.

Results: In total, 649,131 cases of hand and wrist injuries were identified in the NEISS from 2009 to 2018, correlating to 25,666,596 patients nationally. Incidence rates for finger, hand, and wrist were 450, 264, and 182 per 100,000 people. The estimated number of patients per year declined by 8.6% from 2009 to 2018. Male adults (aged 18-39) were the most frequent demographic. Total national estimates of hand (-8.2%; p = 0.001), wrist (-6.1%; p = 0.007), and finger (-9.9%; p < 0.001) injuries declined over the study period. The most common injuries were lacerations (36.5%), fractures (19.9%), strains/sprains (12.3%), and contusions/abrasions (12.1%) which significantly declined over the study period. The overall admission rate was 1.8%.

Conclusions: The estimated annual number of hand/wrist injuries presenting to US EDs was 2.6 million with gradual decline over the decade. Hand injury registries could assist in quality improvement measures targeted toward increased efficiency and resource allocation and education.