Epidemiology of pediatric hand injuries presenting to United States emergency departments, 1990 to 2009.

BACKGROUND: The goal of this study is to describe the epidemiology of hand injuries among children treated in US emergency departments (EDs), including the consumer products and activities most commonly associated with these injuries.

METHODS: A retrospective analysis was conducted of data from the National Electronic Injury Surveillance System for patients younger than 18 years, who were treated in an ED for hand injuries from 1990 through 2009. Sample weights were applied to calculate national estimates, and US Census Bureau data were used to determine injury rates.

RESULTS: An estimated 16,373,757 (95% confidence interval: 14,082,965-18,664,551) children younger than 18 years were treated in EDs for hand injuries from 1990 through 2009 with a mean annual injury number of 818,688 and rate of 11.6 per 1,000 population. There was a statistically significant decrease in the annual number (by 20.5%) and rate (by 31.5%) of hand injuries during the 20-year study period. Males accounted for 65.3% of hand injuries. Injuries most commonly occurred in the home (57.7%) and were most frequently diagnosed as lacerations (31.3%). Patients aged 10 years to 14 years were most frequently diagnosed with fractures (26.7%) and were 1.71 (95% confidence interval: 1.68-1.75) times more likely to be diagnosed with a fracture than patients in other age groups. Hand injuries commonly occurred with products/activities associated with sports/recreational activities (36.4%).

CONCLUSION: Hand injuries are a common and preventable source of pediatric morbidity. Prevention efforts should target the home environment and sport/recreational activities.

LEVEL OF EVIDENCE: Epidemiological study, level III.