Introduction: It has been shown previously that disparities exist in treatment in the USA. We evaluated if disparities exist in patients sustaining upper extremity injuries below the elbow (UEIBE) managed at a single level 1 trauma center in the United States.
Methods: The number of UEIBE seen from 2010-2014 were determined using the trauma registry. ICD-9 codes were used to identify patients undergoing amputation on the UEIBE. Patient demographic, injury, and clinical variables were compared.
Results: There were 2059 patients from 2010-2014, with UEIBE and 77 (3.7%) required amputation. Injury severity score was significantly higher (p<0.0001) for patients not receiving amputation. Time to admission was also longer for those not undergoing amputation (p=0.0005). Those who underwent amputation were more likely to be male (p=0.0244). There was no difference for race (p=0.7326), age (p=0.8724), hospital LOS (p=0.0834), ICU LOS (p=0.1463), or time to admission from injury (p=0.4501). Payment type differed significantly by amputation status (p<0.0001).
Conclusion: Amputation is uncommon following UEIBE. Ironically, the ISS was lower for patients receiving amputations. This likely implies, that the below elbow amputation injury was an isolated injury Those requiring amputation were more likely male, presented for treatment sooner, and were more often associated with a work-related injury. This data does not support previous studies’ findings of racial or age disparities. However, this analysis is limited by being at a single center and the limitations associated with the AIS. Further investigations utilizing a multicenter, nationwide database should be performed to verify and validate these results.
