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Epidemiological and Etiological Analysis of 2,179 Digit Amputations from a Single Level I Trauma Center
Maximilian Mayrhofer-Schmid, MD
1, Martin Aman, MD, PhD
1, Leila Harhaus, MD
1; Arne Boecker, MD
2(1)BG Klinikum Unfallkrankenhaus Berlin, Berlin, Berlin, Germany, (2)BG Trauma Center Ludwigshafen, Ludwigshafen am Rhein, Rhineland-Palatinate, Germany
Introduction:Traumatic digit amputations can lead to substantial functional impairment and long-term socioeconomic consequences. A better understanding of their epidemiological patterns and underlying causes is essential to guide preventive efforts and optimize acute care pathways.
Methods:In this retrospective single-center study, 2,179 digit amputations in 1,768 patients treated between 2005 and 2021 were analyzed. Replantation cases with successful outcomes were excluded. Patient demographics, injury mechanisms, anatomical distributions, temporal trends, and surgical management were assessed. Descriptive and comparative statistical methods were used to identify relevant associations.
Results:The study population was predominantly male (89.1%) with a median age of 49 years. Occupational injuries accounted for 38.7% of amputations and were significantly more frequent among younger men (p<0.001). Sharp injuries represented the leading mechanism (50.5%), followed by blunt (33.2%) and avulsion trauma (9.9%). The index finger was most commonly affected (28.2%), with the distal interphalangeal joint being the most frequent amputation level. Amputations proximal to the metacarpophalangeal joint were significantly more frequent in leisure-related injuries (p<0.001) Multi-digit injuries were observed in 17.8% of cases, often associated with leisure trauma (p=0.001). Temporal analysis showed seasonal peaks in July and September, with differences between occupational and leisure-related injuries.
Conclusions:This large-scale analysis offers detailed insights into patterns and mechanisms of digit amputations over 16 years. The data reflect a high incidence among working-age males, with occupational trauma playing a key role. The observed seasonal and weekly trends highlight opportunities for targeted injury prevention. The higher severity of leisure-related injuries suggests a need for improved awareness and safety practices outside the workplace. These findings can contribute to refined prevention strategies and inform clinical decision-making in hand trauma care.
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