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Epidemiology of upper extremity fractures important for US health initiatives
This epidemiological study of upper extremity fractures is the first to utilize a large national cohort of patients of all ages and types of insurances to demonstrate the importance of epidemiological patterns for clinical applications, public health and policy initiatives.
Researchers identified patients from the 2009 State Inpatient Database (SID) and the State Emergency Department Database (SEDD), both from the Healthcare Cost and Utilization Project with ICD-9 codes. There were 27,174,487 emergency room visits from the SID and 10,530,931 inpatient visits from the SEDD. Researchers calculated the annual incidence of upper extremity fractures per 10,000 individuals among the patients included in the study.
Data collected included diagnosis, procedure, demographics, charges and each patient visit, by year.
Findings showed there were 590,193 upper extremity fractures with an annual 67.7 incidence per 10,000 individuals. The most common fractures, based on the findings, were distal radius (DR) and ulna fractures, and hand, proximal humerus and clavicle fractures were the next most commonly seen.
DR fractures were the most common in all age groups except patients aged 18 to 34 years. In those patients, metacarpal and phalangeal fractures were the most common. In patients aged 35 to 49 years, phalangeal fractures were the most commonly seen.
DR fracture incidence was bimodal as rates were the highest in patients aged under 18 years and over 65 years. Phalangeal fractures were most common in men whereas ulna fractures were most common in women.
The rates of phalangeal and metacarpal fractures changed depending on socioeconomic status such that with an increase in patients’ socioeconomic status there was a decrease in the incidence of these fractures, the researchers noted in the study. ‒ by Monica Jaramillo
Disclosure: Karl reports no relevant financial disclosures.