Trends in upper extremity injuries presenting to emergency departments during the COVID-19 pandemic

Albright, Jeremy; Testa, Edward J; Hanna, John; Shipp, Michael M.; Lama, Christopher J; Arcand, Michel A.

doi:10.1016/j.ajem.2022.02.033

Cited by 4 publications

(8 citation statements)

References 28 publications

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Section: Discussionmentioning

confidence: 99%

“…As hand and finger fractures can have a significant impact, both physically and psychologically, on the pediatric population, we wanted to conduct a deeper analysis using the NEISS database to better characterize the etiology of those fractures and how they changed during the first year of the pandemic. This analysis included stratification by age (by year) and sex and characterized specific associated risk factors for injury, while the previous study analyzed overall trends in injuries presenting to US EDs and their respective rates of hospital admission before and after the start of the COVID-19 pandemic 16…”

Section: Discussionmentioning

confidence: 99%

“…A recently published study analyzing the trends of upper extremity injuries presenting to US EDs in a cohort of all ages reported that the incidence of hand and finger injuries, including amputations, contusions, crush, dislocations, fractures, and sprains, decreased during the first year of the COVID-19 pandemic compared with the average incidence of the four prior years. 16 Based off that report, this study sought to further analyze the incidence of hand and finger fractures in the pediatric population. As hand and finger fractures can have a significant impact, both physically and psychologically, on the pediatric population, we wanted to conduct a deeper analysis using the NEISS database to better characterize the etiology of those fractures and how they changed during the first year of the pandemic.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of the Epidemiology and Risk Factors for Hand Fractures in Patients Aged 1 to 19 Presenting to United States Emergency Departments: A Retrospective Study of 21,031 Cases

Albright

Rebello

Kosinski

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Hand fractures are among the most common injuries presenting in pediatric emergency departments (EDs) with incidence reported as high as 624 hand fractures per 100,000 person-years. If gone untreated, these injuries can lead to pain, loss of function, and psychological trauma. The purpose of this study was to identify risk factors and characterize pediatric hand fractures over a 5-year period. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for all hand fractures in patients aged 1 to 19 years presenting to US EDs between 2016 and 2020. Incidence was calculated using US census data. Cases were retrospectively analyzed using age, location of the injury, sex, coronavirus disease-2019 (COVID-19) era, and etiology of injury. Bivariate logistic regression was used where appropriate. Results: A total of 21,031 pediatric hand fractures were identified, representing an estimated 565,833 pediatric hand fractures presenting to EDs between 2016 and 2020. The mean incidence of pediatric hand fractures was 138.3 fractures for 100,000 person-years [95% confidence interval (CI): 136.2-140.4], with a 39.2% decrease in incidence occurring between 2019 and 2020. It was found that 42.2% of the fractures were in patients aged 10 to 14. The incidence of hand fractures for males and females was 97.9 (95% CI: 96.2-99.7) and 40.4 (95% CI: 39.2-41.5), respectively, with the male rate peaking at age 14 and the female rate peaking at age 12. Age, sex, location of the injury, and injury during the COVID-19 pandemic were demonstrated to influence the frequency and etiology of the fracture. Conclusion: This study determined the incidence of pediatric hand fractures presenting to EDs across the United States. In addition, it identified risk factors for common hand fracture etiologies (sports-related, falling, crush, punching) and demonstrated the change in rates of different etiologies of pediatric hand fractures that presented to US EDs during the COVID-19 pandemic. Level of Evidence: Level III—retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Characterization of the Epidemiology and Risk Factors for Hand Fractures in Patients Aged 1 to 19 Presenting to United States Emergency Departments: A Retrospective Study of 21,031 Cases

Albright

Rebello

Kosinski

et al. 2022

Journal of Pediatric Orthopaedics

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“…The NEISS database has been used on many occasions to analyze injury epidemiology within the United States. 2,9,12,15,23,26,41…”

Section: Methodsmentioning

confidence: 99%

“…The NEISS database has been used on many occasions to analyze injury epidemiology within the United States. 2,9,12,15,23,26,41 In this study, annual queries were performed from 2013 to 2020 to extract all MSK injuries for gymnastics participants within the 8-year span. Information regarding the primary body part injured was extracted using the following codes: Ankle (code 37), Elbow (code 32), Finger (code 92), Foot (code 83), Hand (code 82), Head (code 75), Knee (code 35), Lower Arm (code 33), Lower Leg (code 36), Lower Trunk (code 79), Neck (code 89), Shoulder (code 30), Toe (code 93), Upper Arm (code 80), Upper Leg (code 81), Upper Trunk (code 31), and Wrist (code 34).…”

Section: Methodsmentioning

confidence: 99%

Characterization of Musculoskeletal Injuries in Gymnastics Participants From 2013 to 2020

Albright

Meghani

Lemme

et al. 2022

Sports Health: A Multidisciplinary Approach

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Background: Many studies have analyzed gymnastics-related injuries in collegiate and elite athletes, but there is minimal literature analyzing the epidemiological characteristics of injuries in the greater gymnastics community. Hypothesis: A higher incidence of injuries in younger gymnasts between the ages of 6 and 15 years compared with those 16 years and older and a difference in the distribution of injuries between male and female gymnasts. Study Design: Retrospective cross-sectional study. Level of Evidence: Level 3. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for all gymnastics-related musculoskeletal injuries presenting to the emergency department (ED) between 2013 and 2020. Incidence was calculated as per 100,000 person-years using the weighted estimates provided by NEISS and national participation data. Chi-square and column proportion z-testing was used to analyze where appropriate. Results: The incidence of gymnastics-related musculoskeletal injuries was 480.7 per 100,000 person-years. Most ED visits were children between the ages of 6 and 15 years (84.0%). Younger gymnasts (ages 6 to 10) were most likely to experience a lower arm fracture, while those over the age of 10 years were most likely to experience an ankle sprain ( P < 0.01). Men and boys presented with a much greater proportion of shoulder injuries (8.0% vs 3.9%), while women and girls presented with a greater proportion of elbow injuries (9.9 % vs 5.9%) and wrist (10.5% vs 8.3%) injuries ( P < 0.01). Conclusion: As hypothesized, most gymnastics-related injuries between 2013 and 2020 were athletes between 6 and 15 years old. Many of these athletes are attempting new, more difficult, skills and are at increased risk of more acute injury when attempting skills they may be unfamiliar with. Clinical Relevance: With increased pressure to specialize at an early age to maintain competitiveness and learn new, higher-level skills compared with their peers, younger athletes are most susceptible to acute injury. New injury prevention strategies could be implemented to help this high-risk population compete and train safely.

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Trends in Upper Extremity Saw Injuries From 2003 to 2022

Monir,

Nguyen,

McQuillan

et al. 2024

Hand (New York, N,Y.)

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Purpose: Saws are a common source of upper extremity injury. There have been several commercial and government-mandated safety mechanisms designed to reduce the number of saw injuries. We aim to assess the trends in the incidence and impact of saw-related upper extremity injuries over the last 2 decades. Methods: The National Electronic Injury Surveillance System database was queried from January 2003 to December 2022 for upper extremity injuries caused by saws. Summary statistics for primary body part injured and diagnosis were calculated. Linear regression was performed to evaluate trends in the number of injuries over time. Results: An estimated 1.38 million injuries (weighted) presenting to emergency departments were reported from January 2003 to December 2022. Patients had a mean age of 50.5 ± 18.1. Digits (82.2%) accounted for most injuries, followed by hands (11.9%). The lower arm (3.4%), wrist (1.66%), shoulder (0.3%), elbow (0.2%), and upper arm (0.2%) accounted for fewer injuries. There was a downtrend in number of saw injuries over the study period (R = 0.83, R2 = 0.69, p < .001). Subgroup analysis showed decreases in number of injuries to fingers (R = −0.82, R2 = 0.67, p < .001) and wrists (R = −0.61, R2 = 0.37, p = .004). The most common diagnoses were lacerations (69.7%), fractures (12.6%), and amputations (9.9%). Conclusions: Upper extremity saw injuries have significantly decreased over the last 20 years. The fingers and hands account for the vast majority of saw injuries, resulting most commonly in lacerations, fractures, and amputations. Level of Evidence: IV.

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Trends in upper extremity injuries presenting to emergency departments during the COVID-19 pandemic

Cited by 4 publications

References 28 publications

Characterization of the Epidemiology and Risk Factors for Hand Fractures in Patients Aged 1 to 19 Presenting to United States Emergency Departments: A Retrospective Study of 21,031 Cases

Characterization of the Epidemiology and Risk Factors for Hand Fractures in Patients Aged 1 to 19 Presenting to United States Emergency Departments: A Retrospective Study of 21,031 Cases

Characterization of Musculoskeletal Injuries in Gymnastics Participants From 2013 to 2020

Trends in Upper Extremity Saw Injuries From 2003 to 2022

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