Emergency department visits for traumatic hand and wrist injuries in Ontario, Canada: a population-based study.

OBJECTIVE

Hand and wrist injuries send high volumes of patients to Emergency Departments (EDs) internationally but are an understudied health issue in Canada. This population-based descriptive study examined patterns in ED visits for hand and wrist trauma in Ontario, Canada, over 11 years.

METHODS

National Ambulatory Care Reporting System (NACRS) data were used to identify hand and wrist injuries in adults 18-65 years treated in Ontario EDs from 2006 to 2017. Population data from the Ontario Registered Persons Database (RPDB) were used to calculate annual incidence rates and assess temporal trends by sex. NACRS data were used to describe patient and injury characteristics by sex and repeat injury status (index vs. repeat injury).

RESULTS

From 2006 to 2017, Ontario adults experienced 2,045,950 ED visits for hand and wrist trauma. The annual incidence was 211/10,000 persons (269/10,000 men vs. 157/10,000 women). Hand and wrist injuries declined by 9% over time, driven by a 12% decrease in injuries among men. Compared to women, men were younger, more often injured at work, and less often had a history of mental health and addiction (MHA) service use. Twenty-five percent of ED visits for hand and wrist trauma were repeat injuries. Men were overrepresented in the repeat injury group, as were adults living outside of major urban areas, and those with a history of MHA service use.

CONCLUSION

Hand and wrist injuries represent a major public health burden in Ontario. While injury incidence is higher among men than women, men have experienced a significant decline in injuries over time. This study identifies groups that may be at an increased risk for hand and wrist trauma and its recurrence. Additional research is needed to improve our understanding of the modifiable determinants of these injuries with the goal of prevention.