EPIDEMIOLOGY OF TRAUMATIC INJURIES OF THE UPPER LIMBS IN A UNIVERSITY HOSPITAL

To evaluate the epidemiology of traumatic injuries of the upper limbs treated at a university hospital and identify the causes, types of injuries, and risk factors.

Methods:

A prospective study was performed with accidents resulting in trauma categorized into three groups: domestic, occupational, or transportation-related. A questionnaire containing information about the patient and the accident was administered. Lesion characteristics were evaluated according to the injured area, the type of injury, and the management strategy adopted for each case.

Results:

A total of 613 patients were evaluated. The most frequent accidents were domestic (66.6%), predominantly involving men (67.9%) with a mean age of 31 years. Wrist lesions prevailed in transportation-related (31.1%) and domestic (29.6%) accidents, and in accidents involving fingers at work (54.2%). Closed fractures were more frequent and conservative treatment was indicated most often. Serious injuries were associated with finger accidents (39.4%). There was a correlation between the level of education and the type of accident.

Conclusion:

Traumatic injuries of the upper limbs were more frequent in domestic accidents and in male patients. Closed fractures were the most common type of fracture and were usually treated conservatively. Serious injuries were more often related to finger trauma. Education level influenced domestic, transportation-related, and occupational accidents. Level of Evidence IV, Case Series.

Keywords:
Accidents, Occupational; Trauma; Epidemiology; Upper extremity; Hand; Risk factors; Incidence

	Morning		Afternoon		Night		Total
	N	%	N	%	N	%	N	%
Beginning of the week	44	27%	78	30%	39	22%	161	27%
Middle of the week	47	28%	72	28%	53	30%	172	29%
Weekend	74	45%	111	43%	84	48%	269	45%
Total	165	27%	261	43%	176	29%	602	100%

Affected segment	Domestic		Work		Transport
Affected segment	N	%	N	%	N	%
Shoulder	43	10.4%	5	6.0%	27	20.0%
Arm	18	4.4%	1	1.2%	11	8.1%
Elbow	49	11.9%	2	2.4%	9	6.7%
Forearm	47	11.4%	2	2.4%	13	9.6%
Wrist	122	29.6%	14	16.9%	42	31.1%
Hand	61	14.8%	15	18.1%	16	11.9%
Fingers	67	16.3%	45	54.2%	20	14.8%
Multiple injuries	5	1,2%	1	1.2%	3	2.2%
Total	412		83		135

Tipo de Ferimento	Domestic		Work		Transport
Tipo de Ferimento	N	%	N	%	N	%
Closed fracture	300	72.8%	41	49.4%	117	86.7%
Open fracture	27	6.6%	17	20.5%	10	7.4%
Laceration/Perforation/Cut	17	4.1%	10	12.0%	3	2.2%
Tendon lesion	21	5.1%	8	9.6%	1	0.7%
Neurologic lesion	4	1.0%	0	0.0%	1	0.7%
Vascular lesion	1	0.2%	0	0.0%	0	0.0%
Dislocation	43	10.4%	5	6.0%	10	7.4%
Amputation	3	0.7%	4	4.8%	0	0.0%
Complex injury	0	0.0%	2	2.4%	0	0.0%
Total	412		83		135

Management	Domestic		Work		Transport
Management	N	%	N	%	N	%
Treatment conservative	329	79.9%	49	59.0%	104	77.0%
Surgical treatment	77	18.7%	32	38.6%	29	21.5%
Inpatient	0	0,0%	0	0.0%	1	0.7%
Avoidance	1	0.2%	0	0.0%	0	0.0%
No response	1	0.2%	0	0.0%	0	0.0%
Total	412		83		135

Follow-up	N	%	P value
Fingers	67	39.4%	<0.0001
Wrist	34	20.0%	<0.0001
Hand	20	11.8%	<0.0001
Elbow	13	7.6%	<0.0001
Forearm	13	7.6%	<0.0001
Arm	12	7.1%	<0.0001
Shoulder	6	3.5%	<0.0001
Multiple injuries	5	2.9%	<0.0001
Total	170

		Domestic		Work		Transport		Total		P value
		N	%	N	%	N	%	N	%	P value
Alcohol	Yes	350	89%	73	96%	106	87%	529	90%	0.110
Alcohol	No	42	11%	3	4%	16	13%	61	10%
Education	Illiterate	77	20%	3	4%	7	6%	87	15%
	Primary	182	48%	37	51%	54	46%	273	48%	<0.001
	Secondary	106	28%	29	40%	50	42%	185	32%
	Higher	14	4%	4	5%	7	6%	25	4%

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[1] Correspondence: Samuel Ribak. Rua das Hortências 451, Chácaras Vale do Rio Cotia, Carapicuíba, SP, Brasil. 06355-370. E-mail: ribaksamuel@yahoo.com.br