The frequency and epidemiology of hand and forearm fractures in the United States


      The purpose of this study was to estimate the frequency and describe the epidemiology of hand and forearm fractures in the United States. We extracted cases with ICD-9-CM diagnostic codes of 813.0 to 817.1 from the 1998 National Hospital Ambulatory Medical Care Survey. In 1998 there were 1,465,874 estimated cases of hand/forearm fractures, accounting for 1.5% of all emergency department cases. Radius and/or ulna fractures comprised the largest proportion of fractures (44%). The most affected age group was 5 to 14 years of age (26%). Private insurance paid for 49% of the cases. Most of the fractures occurred at home (30%); the street/highway was the second most likely fracture location (14%). Accidental falls caused the majority (47%) of fractures. Large database analysis provides important information that can be used to target interventions toward vulnerable populations and to allocate adequate resources for treating upper extremity fractures. (J Hand Surg 2001;26A:908-915. Copyright © 2001 by the American Society for Surgery of the Hand.)


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        • Kelsey J
        • Praemer A
        • Nelson L
        • Felberg A
        • Rice DP
        Upper extremity disorders: frequency, impact, and cost.
        in: : Churchill Livingstone, New York1997: 10 (34,40,48)
        • Johns AM
        Time off work after hand injury.
        Injury. 1981; 12: 417-424
        • de Jonge JJ
        • Kingma J
        • van der Lei B
        • Klasen HJ
        Phalangeal fractures of the hand: an analysis of gender and age-related incidence and aetiology.
        J Hand Surg. 1994; 19B: 168-170
        • McCaig LF
        National hospital ambulatory medical care survey: 1998 emergency department summary..
        Advance data from vital and health statistics, no. 313. : National Center for Health Statistics, Hyattsville, MD2000
        • US Dept of Health and Human Services, National Center for Health Statistics
        National hospital ambulatory medical care survey, 1998..
        ([computer file] ICPSR version) : U.S. Dept. of Health and Human Services, National Center for Health Statistics [producer], 2000, Hyattsville, MD2000Ann Arbor. Inter-university Consortium for Political and Social Research [distributor], MI:2000
      1. International classification of diseases, 9th rev, clinical modification. : Public Health Service, US Dept of Health and Human Services, Washington, DC2001
        • Hennekens CH
        • Buring JE
        Epidemiology in medicine.
        in: : Little, Brown, Boston1987: 239
        • Census Bureau US
        Annual postcensal resident population, by single year of age, sex, race.
        • Bhende MS
        • Dandrea LA
        • Davis HW
        Hand injuries in children presenting to a pediatric emergency department.
        Ann Emerg Med. 1993; 22: 1519-1523
        • Frazier WH
        • Miller M
        • Fox RS
        • Brand D
        • Finseth F
        Hand injuries: incidence and epidemiology in an emergency service.
        JACEP. 1978; 7: 265-268
        • Absoud EM
        • Harrop SN
        Hand injuries at work.
        J Hand Surg. 1984; 9B: 211-215
        • Smith ME
        • Auchincloss JM
        • Ali MS
        Causes and consequences of hand injury.
        J Hand Surg. 1985; 10B: 288-292
        • Angermann P
        • Lohmann M
        Injuries to the hand and wrist: a study of 50,272 injuries.
        J Hand Surg. 1993; 18B: 642-644
        • Goldwyn RM
        • Day LH
        Acute industrial hand injuries: a socio-medical study.
        Plast Reconstr Surg. 1969; 44: 567-575
        • Edwards DH
        The spectrum of hand injuries.
        Hand. 1975; 7: 46-50
        • Page RE
        Hand injuries at work.
        Hand. 1975; 7: 51-55
        • Hill C
        • Riaz M
        • Mozzam A
        • Brennen MD
        A regional audit of hand and wrist injuries.
        J Hand Surg. 1998; 23B: 196-200
        • Clark DP
        • Scott RN
        • Anderson IWR
        Hand problems in an accident and emergency department.
        J Hand Surg. 1985; 10B: 297-299
        • Hove LM
        Fractures of the hand: distribution and relative incidence.
        Scand J Plast Reconstr Hand Surg. 1993; 27: 317-319
        • Robertsson GO
        • Jonsson GT
        • Sigurjonsson K
        Epidemiology of distal radius fractures in Iceland in 1985.
        Acta Orthop Scand. 1990; 61: 457-459
        • de Jonge JJ
        • Kingma J
        • van der Lei B
        • Klasen HJ
        Fractures of the metacarpals: a retrospective analysis of incidence and aetiology and a review of the English-language literature.
        Injury. 1994; 25: 365-369
        • Mathers LJ
        • Weiss HB
        Incidence and characteristics of fall-related emergency department visits.
        Acad Emerg Med. 1998; 5: 1064-1070
        • Bureau of Labor Statistics
        Nonfatal occupational injuries and illnesses from the Survey of Occupational Injuries and Illnesses: industry counts and frequency rates.
        • The Institute for the Future
        Health and health care 2010: the forecast, the challenge.
        : Jossey-Bass, San Francisco2000
        • Jager TE
        • Weiss HB
        • Coben JH
        • Pepe PE
        Traumatic brain injuries evaluated in U.S. emergency departments, 1992-1994.
        Acad Emerg Med. 2000; 7: 134-140
        • Guerrero JL
        • Thurman DJ
        • Sniezek JE
        Emergency department visits associated with traumatic brain injury: United States, 1995-1996.
        Brain Inj. 2000; 14: 181-186
        • Nash EA
        • Margo CE
        Patterns of emergency department visits for disorders of the eye and ocular adnexa.
        Arch Ophthalmol. 1998; 116: 1222-1226