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Epidemiology of Hand and Forearm Fractures in U.S. Emergency Departments: Analysis of 2022 NHAMCS Data
Kierstyn M Smith, BA, MPH
1, Nicholas Mirsky, B.S.
2, Derek K Nuamah, BA
1; Kashyap K Tadisina, MD
2(1)University of Miami Miller School of Medicine, Miami, FL, (2)University of Miami, Miami, FL
Background:Hand and forearm fractures are among the most common orthopedic injuries, previously estimated to constitute 1.5% of emergency department (ED) visits in the United States. Since then, demographic shifts, changes in injury mechanisms, and new safety practices may have influenced national trends. This study provides an modern update using 2022 National Hospital Ambulatory Medical Care Survey (NHAMCS) data.
Methods:Using the 2022 NHAMCS dataset, we identified all ED visits with ICD-10 codes corresponding to hand and forearm fractures (S52-S62). Weighted national estimates were calculated. Variables analyzed included fracture subtype, age, sex, race/ethnicity, insurance status, injury mechanism, and location. Analyses were performed using SAS 9.4 per NCHS guidelines.
Results:An estimated 1,486,000 ED visits were attributable to hand and forearm fractures in 2022, representing 0.96% of all visits-down from 1.5% in 1998. Radius and/or ulna fractures were most common (45.1%), followed by phalanges (27.3%) and metacarpals (15.3%). Fracture patterns varied by age, with bimodal peaks in children (5-14 years) and older adults (?75 years). Gender differences were significant: women had higher rates of forearm fractures, while men had higher rates of phalangeal, metacarpal, and carpal fractures. Hispanic individuals had the highest rates of phalangeal and metacarpal fractures. Medicaid/public insurance covered 44% of cases. Falls accounted for 31% of fractures, with slipping/tripping and falls from one level to another being the most common causes.
Conclusion:The incidence of hand and forearm fractures as a proportion of ED visits has declined since 1998, though demographic and etiological patterns persist. These findings underscore the need for targeted injury prevention and resource allocation strategies, especially for high-risk age and ethnic groups.
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