Global trends of hand and wrist trauma: A systematic analysis of the Global Burden of Disease 2017 Study

Journal:

BMJ Injury Prevention

Author(s):

James Chang

Additional Authors: Christopher Stephen Crowe 1, Benjamin Ballard Massenburg 2, Shane Douglas Morrison 2, Jeffrey Barton Friedrich 2, Gdiom Gebreheat Abady 4, Fares Alahdab 5, Vahid Alipour 6 7, Jalal Arabloo 6, Malke Asaad 8, Maciej Banach 9 10, Ali Bijani 11, Antonio Maria Borzì 12, Nikolay Ivanovich Briko 13, Chris D Castle 14, Daniel Youngwhan Cho 2, Michael T Chung 15, Ahmad Daryani 16, Gebre Teklemariam Demoz 17 18, Zachary V Dingels 14, Hoa Thi Do 19, Florian Fischer 20, Jack T Fox 14, Takeshi Fukumoto 21 22, Abadi Kahsu Gebre 23, Berhe Gebremichael 24, Juanita A Haagsma 25, Arvin Haj-Mirzaian 26 27, Demelash Woldeyohannes Handiso 28, Simon I Hay 14 29, Chi Linh Hoang 30, Seyed Sina Naghibi Irvani 31, Jacek Jerzy Jozwiak 32, Rohollah Kalhor 33, Amir Kasaeian 34 35, Yousef Saleh Khader 36, Rovshan Khalilov 37, Ejaz Ahmad Khan 38, Roba Khundkar 39, Sezer Kisa 40, Adnan Kisa 41, Zichen Liu 14, Marek Majdan 42, Navid Manafi 43 44, Ali Manafi 45, Ana-Laura Manda 46, Tuomo J Meretoja 47 48, Ted R Miller 49 50, Abdollah Mohammadian-Hafshejani 51, Reza Mohammadpourhodki 52, Mohammad A Mohseni Bandpei 53, Ali H Mokdad 14 29, Mukhammad David Naimzada 54 55, Duduzile Edith Ndwandwe 56, Cuong Tat Nguyen 57, Huong Lan Thi Nguyen 57, Andrew T Olagunju 58 59, Tinuke O Olagunju 60, Hai Quang Pham 57, Dimas Ria Angga Pribadi 61, Navid Rabiee 62, Kiana Ramezanzadeh 63, Kavitha Ranganathan 64, Nicholas L S Roberts 14, Leonardo Roever 65, Saeed Safari 66, Abdallah M Samy 67, Lidia Sanchez Riera 68 69, Saeed Shahabi 70, Catalin-Gabriel Smarandache 71 72, Dillon O Sylte 14, Berhe Etsay Tesfay 73, Bach Xuan Tran 74, Irfan Ullah 75 76, Parviz Vahedi 77, Amir Vahedian-Azimi 78, Theo Vos 14 29, Dawit Habte Woldeyes 79, Adam Belay Wondmieneh 80 81, Zhi-Jiang Zhang 82, Spencer L James 14
Topic(s):
Outcomes and Impact
Trauma
Hand
Measurement
Follow Up and Outcomes
OPEN PUBLICATION
Background: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period.

Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations.

Results: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%.

Conclusions: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.