Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

doi:10.1136/injuryprev-2019-043495

. 2020 Oct;26(Supp 1):i115-i124.

doi: 10.1136/injuryprev-2019-043495. Epub 2020 Mar 13.

Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

Christopher Stephen Crowe¹, Benjamin Ballard Massenburg², Shane Douglas Morrison², James Chang³, Jeffrey Barton Friedrich², Gdiom Gebreheat Abady⁴, Fares Alahdab⁵, Vahid Alipour^{6

7}, Jalal Arabloo⁶, Malke Asaad⁸, Maciej Banach^{9

10}, Ali Bijani¹¹, Antonio Maria Borzì¹², Nikolay Ivanovich Briko¹³, Chris D Castle¹⁴, Daniel Youngwhan Cho², Michael T Chung¹⁵, Ahmad Daryani¹⁶, Gebre Teklemariam Demoz^{17

18}, Zachary V Dingels¹⁴, Hoa Thi Do¹⁹, Florian Fischer²⁰, Jack T Fox¹⁴, Takeshi Fukumoto^{21

22}, Abadi Kahsu Gebre²³, Berhe Gebremichael²⁴, Juanita A Haagsma²⁵, Arvin Haj-Mirzaian^{26

27}, Demelash Woldeyohannes Handiso²⁸, Simon I Hay^{14

29}, Chi Linh Hoang³⁰, Seyed Sina Naghibi Irvani³¹, Jacek Jerzy Jozwiak³², Rohollah Kalhor³³, Amir Kasaeian^{34

35}, Yousef Saleh Khader³⁶, Rovshan Khalilov³⁷, Ejaz Ahmad Khan³⁸, Roba Khundkar³⁹, Sezer Kisa⁴⁰, Adnan Kisa⁴¹, Zichen Liu¹⁴, Marek Majdan⁴², Navid Manafi^{43

44}, Ali Manafi⁴⁵, Ana-Laura Manda⁴⁶, Tuomo J Meretoja^{47

48}, Ted R Miller^{49

50}, Abdollah Mohammadian-Hafshejani⁵¹, Reza Mohammadpourhodki⁵², Mohammad A Mohseni Bandpei⁵³, Ali H Mokdad^{14

29}, Mukhammad David Naimzada^{54

55}, Duduzile Edith Ndwandwe⁵⁶, Cuong Tat Nguyen⁵⁷, Huong Lan Thi Nguyen⁵⁷, Andrew T Olagunju^{58

59}, Tinuke O Olagunju⁶⁰, Hai Quang Pham⁵⁷, Dimas Ria Angga Pribadi⁶¹, Navid Rabiee⁶², Kiana Ramezanzadeh⁶³, Kavitha Ranganathan⁶⁴, Nicholas L S Roberts¹⁴, Leonardo Roever⁶⁵, Saeed Safari⁶⁶, Abdallah M Samy⁶⁷, Lidia Sanchez Riera^{68

69}, Saeed Shahabi⁷⁰, Catalin-Gabriel Smarandache^{71

72}, Dillon O Sylte¹⁴, Berhe Etsay Tesfay⁷³, Bach Xuan Tran⁷⁴, Irfan Ullah^{75

76}, Parviz Vahedi⁷⁷, Amir Vahedian-Azimi⁷⁸, Theo Vos^{14

29}, Dawit Habte Woldeyes⁷⁹, Adam Belay Wondmieneh^{80

81}, Zhi-Jiang Zhang⁸², Spencer L James¹⁴

Affiliations

¹ Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA ccrowe2@uw.edu.
² Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA.
³ Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA.
⁴ College of Medicine and Health Sciences, Department of Nursing, Adigrat University, Adigrat, Ethiopia.
⁵ Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA.
⁶ Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁷ Health Economics Department, Iran University of Medical Sciences, Tehran, Iran.
⁸ Plastic Surgery Department, University of Texas, Houston, Texas, USA.
⁹ Department of Hypertension, Medical University of Lodz, Lodz, Poland.
¹⁰ Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland.
¹¹ Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran.
¹² Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
¹³ Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
¹⁴ Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
¹⁵ Department of Otolaryngology - Head & Neck Surgery, Wayne State University, Detroit, Michigan, USA.
¹⁶ Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
¹⁷ School of Pharmacy, Aksum University, Aksum, Ethiopia.
¹⁸ Addis Ababa University, Addis Ababa, Ethiopia.
¹⁹ Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
²⁰ Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany.
²¹ Department of Dermatology, Kobe University, Kobe, Japan.
²² Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA.
²³ School of Pharmacy, Mekelle University, Mekelle, Ethiopia.
²⁴ School of Public Health, Haramaya University, Harar, Ethiopia.
²⁵ Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
²⁶ Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran.
²⁷ Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
²⁸ Public Health Department, Madda Walabu University, Bale Goba, Ethiopia.
²⁹ Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA.
³⁰ Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
³¹ Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³² Department of Family Medicine and Public Health, University of Opole, Opole, Poland.
³³ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
³⁴ Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³⁵ Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran.
³⁶ Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan.
³⁷ Department of Physiology, Baku State University, Baku, Azerbaijan.
³⁸ Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan.
³⁹ Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK.
⁴⁰ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁴¹ School of Health Sciences, Kristiania University College, Oslo, Norway.
⁴² Department of Public Health, Trnava University, Trnava, Slovakia.
⁴³ Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran.
⁴⁴ Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada.
⁴⁵ Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran.
⁴⁶ Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania.
⁴⁷ Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.
⁴⁸ University of Helsinki, Helsinki, Finland.
⁴⁹ Pacific Institute for Research & Evaluation, Calverton, Maryland, USA.
⁵⁰ School of Public Health, Curtin University, Perth, Western Australia, Australia.
⁵¹ Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran.
⁵² Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran.
⁵³ Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
⁵⁴ Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia.
⁵⁵ Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia.
⁵⁶ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
⁵⁷ Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam.
⁵⁸ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
⁵⁹ Department of Psychiatry, University of Lagos, Lagos, Nigeria.
⁶⁰ Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
⁶¹ Health Sciences Department, Muhammadiyah University of Surakarta, Sukoharjo, Indonesia.
⁶² Department of Chemistry, Sharif University of Technology, Tehran, Iran.
⁶³ Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶⁴ Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
⁶⁵ Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil.
⁶⁶ Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶⁷ Department of Entomology, Ain Shams University, Cairo, Egypt.
⁶⁸ Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
⁶⁹ Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia.
⁷⁰ Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁷¹ Surgery 2nd Department - SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁷² Surgery 2nd Department, Bucharest Emergency Hospital, Bucharest, Romania.
⁷³ Department of Public Health, Adigrat University, Adigrat, Ethiopia.
⁷⁴ Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam.
⁷⁵ Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan.
⁷⁶ TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan.
⁷⁷ Department of Anatomical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran.
⁷⁸ Trauma Research Center, Nursing Facility, Baqiyatallah University of Medical Sciences, Tehran, Iran.
⁷⁹ Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia.
⁸⁰ Department of Nursing, Wollo University, Dessie, Ethiopia.
⁸¹ Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia.
⁸² Department of Preventive Medicine, Wuhan University, Wuhan, China.

PMID: 32169973
PMCID: PMC7571361
DOI: 10.1136/injuryprev-2019-043495

Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

Christopher Stephen Crowe et al. Inj Prev. 2020 Oct.

. 2020 Oct;26(Supp 1):i115-i124.

doi: 10.1136/injuryprev-2019-043495. Epub 2020 Mar 13.

Authors

Affiliations

¹ Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA ccrowe2@uw.edu.
² Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington, USA.
³ Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA.
⁴ College of Medicine and Health Sciences, Department of Nursing, Adigrat University, Adigrat, Ethiopia.
⁵ Evidence Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota, USA.
⁶ Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁷ Health Economics Department, Iran University of Medical Sciences, Tehran, Iran.
⁸ Plastic Surgery Department, University of Texas, Houston, Texas, USA.
⁹ Department of Hypertension, Medical University of Lodz, Lodz, Poland.
¹⁰ Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland.
¹¹ Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran.
¹² Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
¹³ Epidemiology and Evidence Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
¹⁴ Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
¹⁵ Department of Otolaryngology - Head & Neck Surgery, Wayne State University, Detroit, Michigan, USA.
¹⁶ Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
¹⁷ School of Pharmacy, Aksum University, Aksum, Ethiopia.
¹⁸ Addis Ababa University, Addis Ababa, Ethiopia.
¹⁹ Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
²⁰ Department of Population Medicine and Health Services Research, Bielefeld University, Bielefeld, Germany.
²¹ Department of Dermatology, Kobe University, Kobe, Japan.
²² Gene Expression & Regulation Program, The Wistar Institute, Philadelphia, Pennsylvania, USA.
²³ School of Pharmacy, Mekelle University, Mekelle, Ethiopia.
²⁴ School of Public Health, Haramaya University, Harar, Ethiopia.
²⁵ Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
²⁶ Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran.
²⁷ Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
²⁸ Public Health Department, Madda Walabu University, Bale Goba, Ethiopia.
²⁹ Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA.
³⁰ Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
³¹ Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³² Department of Family Medicine and Public Health, University of Opole, Opole, Poland.
³³ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
³⁴ Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³⁵ Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran.
³⁶ Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan.
³⁷ Department of Physiology, Baku State University, Baku, Azerbaijan.
³⁸ Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan.
³⁹ Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK.
⁴⁰ Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁴¹ School of Health Sciences, Kristiania University College, Oslo, Norway.
⁴² Department of Public Health, Trnava University, Trnava, Slovakia.
⁴³ Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran.
⁴⁴ Ophthalmology Department, University of Manitoba, Winnipeg, Manitoba, Canada.
⁴⁵ Plastic Surgery Department, Iran University of Medical Sciences, Tehran, Iran.
⁴⁶ Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania.
⁴⁷ Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland.
⁴⁸ University of Helsinki, Helsinki, Finland.
⁴⁹ Pacific Institute for Research & Evaluation, Calverton, Maryland, USA.
⁵⁰ School of Public Health, Curtin University, Perth, Western Australia, Australia.
⁵¹ Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran.
⁵² Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran.
⁵³ Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
⁵⁴ Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia.
⁵⁵ Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia.
⁵⁶ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
⁵⁷ Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam.
⁵⁸ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
⁵⁹ Department of Psychiatry, University of Lagos, Lagos, Nigeria.
⁶⁰ Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
⁶¹ Health Sciences Department, Muhammadiyah University of Surakarta, Sukoharjo, Indonesia.
⁶² Department of Chemistry, Sharif University of Technology, Tehran, Iran.
⁶³ Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶⁴ Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
⁶⁵ Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil.
⁶⁶ Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶⁷ Department of Entomology, Ain Shams University, Cairo, Egypt.
⁶⁸ Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
⁶⁹ Institute of Bone and Joint Research, University of Sydney, Syndey, New South Wales, Australia.
⁷⁰ Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁷¹ Surgery 2nd Department - SUUB, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
⁷² Surgery 2nd Department, Bucharest Emergency Hospital, Bucharest, Romania.
⁷³ Department of Public Health, Adigrat University, Adigrat, Ethiopia.
⁷⁴ Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam.
⁷⁵ Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan.
⁷⁶ TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan.
⁷⁷ Department of Anatomical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran.
⁷⁸ Trauma Research Center, Nursing Facility, Baqiyatallah University of Medical Sciences, Tehran, Iran.
⁷⁹ Department of Human Anatomy, Histology, and Embryology, Bahir Dar University, Bahir Dar, Ethiopia.
⁸⁰ Department of Nursing, Wollo University, Dessie, Ethiopia.
⁸¹ Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia.
⁸² Department of Preventive Medicine, Wuhan University, Wuhan, China.

PMID: 32169973
PMCID: PMC7571361
DOI: 10.1136/injuryprev-2019-043495

Abstract

Background: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period.

Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations.

Results: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%.

Conclusions: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.

Keywords: burden of disease; descriptive epidemiology; hand injury.

PubMed Disclaimer

Conflict of interest statement

Competing interests: Dr. Jozwiak reports personal fees from TEVA, personal fees from ALAB, personal fees from BOEHRINGER INGELHEIM, personal fees from SYNEXUS, non-financial support from SERVIER, non-financial support from MICROLIFE, and non-financial support from MEDICOVER, outside the submitted work. Dr. James reports grants from Sanofi Pasteur, outside the submitted work.

Figures

**Figure 1**
Age-standardised incidence rate of hand and wrist fractures in 2017 (A) and percentage change in hand and wrist fracture incidence rate from 1990 to 2017 (B).

**Figure 2**
Age-standardised incidence rate of thumb amputations in 2017 (A) and percentage change in thumb amputation incidence rate from 1990 to 2017 (B).

**Figure 3**
Age-standardised incidence rate of non-thumb digit amputations in 2017 (A) and percentage change in non-thumb digit amputation incidence rate from 1990 to 2017 (B).

**Figure 4**
Age-standardised incidence of hand and wrist trauma by Socio-demographic Index (SDI).

**Figure 5**
Causes of hand and wrist fracture (A), thumb amputation (B) and non-thumb digit amputation (C) by region.

See this image and copyright information in PMC

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References

1. James SL, Abate D, Abate KH, et al. . Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018;392:1789–858. 10.1016/S0140-6736(18)32279-7 - DOI - PMC - PubMed
1. Emmett JE, Breck LW. A review and analysis of 11,000 fractures seen in a private practice of orthopaedic surgery, 1937-1956. J Bone Joint Surg Am 1958;40-A:1169–75. 10.2106/00004623-195840050-00025 - DOI - PubMed
1. Huisstede BMA, Bierma-Zeinstra SMA, Koes BW, et al. . Incidence and prevalence of upper-extremity musculoskeletal disorders. A systematic appraisal of the literature. BMC Musculoskelet Disord 2006;7:7 10.1186/1471-2474-7-7 - DOI - PMC - PubMed
1. Robinson LS, Sarkies M, Brown T, et al. . Direct, indirect and intangible costs of acute hand and wrist injuries: a systematic review. Injury 2016;47:2614–26. 10.1016/j.injury.2016.09.041 - DOI - PubMed
1. Case-Smith J. Outcomes in hand rehabilitation using occupational therapy services. Am J Occup Ther 2003;57:499–506. 10.5014/ajot.57.5.499 - DOI - PubMed

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[1] James SL, Abate D, Abate KH, et al. . Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018;392:1789–858. 10.1016/S0140-6736(18)32279-7 - DOI - PMC - PubMed

[2] James SL, Abate D, Abate KH, et al. . Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018;392:1789–858. 10.1016/S0140-6736(18)32279-7 - DOI - PMC - PubMed

[3] Emmett JE, Breck LW. A review and analysis of 11,000 fractures seen in a private practice of orthopaedic surgery, 1937-1956. J Bone Joint Surg Am 1958;40-A:1169–75. 10.2106/00004623-195840050-00025 - DOI - PubMed

[4] Emmett JE, Breck LW. A review and analysis of 11,000 fractures seen in a private practice of orthopaedic surgery, 1937-1956. J Bone Joint Surg Am 1958;40-A:1169–75. 10.2106/00004623-195840050-00025 - DOI - PubMed

[5] Huisstede BMA, Bierma-Zeinstra SMA, Koes BW, et al. . Incidence and prevalence of upper-extremity musculoskeletal disorders. A systematic appraisal of the literature. BMC Musculoskelet Disord 2006;7:7 10.1186/1471-2474-7-7 - DOI - PMC - PubMed

[6] Huisstede BMA, Bierma-Zeinstra SMA, Koes BW, et al. . Incidence and prevalence of upper-extremity musculoskeletal disorders. A systematic appraisal of the literature. BMC Musculoskelet Disord 2006;7:7 10.1186/1471-2474-7-7 - DOI - PMC - PubMed

[7] Robinson LS, Sarkies M, Brown T, et al. . Direct, indirect and intangible costs of acute hand and wrist injuries: a systematic review. Injury 2016;47:2614–26. 10.1016/j.injury.2016.09.041 - DOI - PubMed

[8] Robinson LS, Sarkies M, Brown T, et al. . Direct, indirect and intangible costs of acute hand and wrist injuries: a systematic review. Injury 2016;47:2614–26. 10.1016/j.injury.2016.09.041 - DOI - PubMed

[9] Case-Smith J. Outcomes in hand rehabilitation using occupational therapy services. Am J Occup Ther 2003;57:499–506. 10.5014/ajot.57.5.499 - DOI - PubMed

[10] Case-Smith J. Outcomes in hand rehabilitation using occupational therapy services. Am J Occup Ther 2003;57:499–506. 10.5014/ajot.57.5.499 - DOI - PubMed

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Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

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Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

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