The burden of wrist joint dislocations: A nationwide 20-year analysis and review of incidence and injury mechanism.

BACKGROUND

Wrist dislocations are rare injuries that present substantial diagnostic challenges, yet large-scale epidemiological data on injury mechanisms and trends are limited. This study characterizes wrist dislocation epidemiology using nationally representative emergency department data from 2004 to 2023.

METHODS

A retrospective analysis was performed using the National Electronic Injury Surveillance System (NEISS) database to estimate national wrist dislocation trends. Cases were identified by diagnosis and body part codes. Demographics, mechanisms, and annual incidence were examined. Trends were assessed using linear regression; group differences were assessed using Odds Ratios (OR) and Injury Proportion Ratios (IPR).

RESULTS

Among 21,237 estimated cases (3.42/1,000,000 population), males accounted for 64.2% of dislocations, with a 4.38/1,000,000 incidence vs. 2.40/1,000,000 in females (p < 0.001). Peak incidence was among ages 25-44 years (17.49 per 1,000,000 US population; male-to-female [M:F] IPR 3.59). Females demonstrated bimodal vulnerability: <5 years (IPR 1.85) and ≥65 years (IPR 1.52). Athletic dislocations (19.7%) mainly involved males in football (16.0%) and snowboarding (12.8%). Non-athletic dislocations (80.3%) disproportionately affected females (OR 3.02) and individuals ≥50 years (OR 4.68), with home environments posing elevated risks (female OR 2.22).

CONCLUSIONS

This national analysis characterizes wrist dislocation epidemiology, revealing a stable incidence despite rising sports participation. Key demographic disparities were identified, including high-risk groups of young males (15-24) and females at bimodal age peaks (<5 and ≥65 years). This descriptive epidemiological analysis provides a foundational baseline to inform future clinical research on management and outcomes within these specific populations.