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Injuries Associated with Operative Upper Extremity Trauma

Christopher Ingersol, MD, Scott Loewenstein, MD, Joshua Adkinson, MD
Indiana University
2020-02-15

Presenter: Christopher Ingersol

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.

Director Name: William Wooden

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand

Background: Traumatic injuries of the hand and upper extremity are common but risk being overlooked due to other distracting traumatic injuries. Whereas, these injuries are rarely life threatening, they can contribute to significant morbidity if left unaddressed. In this study, we sought to identify the most common injuries associated with operative upper extremity trauma.

Methods: Data was collected using the National Trauma Data Bank (NTDB). Patients who presented as a trauma consult to participating hospitals and underwent intervention for their hand and upper extremity injury were selected. These patients were identified based on CPT codes. Statistical analysis was performed using STATA (StataCorp, College Station, TX).

Results: A total of 394,877 patients between 2011-2016 were identified as undergoing hand and upper extremity intervention. The most frequent procedures performed included open reduction and internal fixation (ORIF) of the radius or ulna, ORIF of the humerus, closed reduction of the radius or ulna, closed reduction internal fixation of the humerus, ORIF of phalanges of the hand, and urgent carpal tunnel release. The most frequently associated non-upper extremity diagnoses included fractures of lumbar and thoracic vertebrae, acetabular fractures, rib fractures, and closed nasal bone fractures.

Conclusion: Understanding patterns of trauma associated with hand and upper extremity injury requiring intervention is important in the trauma setting. The appropriate patient workup should be initiated by trauma and emergency medicine providers and streamline consultation to the hand surgeon for definitive care.

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