Hand Injuries in the Elder Population

Abstract

Objective/Hypothesis: Hand injuries occur at all ages, and with a globally aging population, an increasing number of hand injuries among the elderly can be expected. The aim was to describe the health characteristics and detailed injury patterns for elderly with hand injuries and study if any changes were noticed in the number of hand injuries over time. Materials and Methods: All patients with an age of more than 65 years and admitted to a hand surgery ward with a hand injury were retrospectively collected at 4 different 2-year periods over 30 years (1980-1981 to 2010-2011). Also all patients, older than 65 years, who had been treated at the department of hand surgery for a traumatic hand injury that occurred between July 1, 2013, and June 31, 2014, were included. Data were collected retrospectively. Results: The number of injuries increased over the 30-year study period. The incidence was 21.3/10 000 inhabitants/year. Two hundred eighty-six patients were included (145 women and 141 men). One patient was injured twice, resulting in 287 injuries; 188 (65%) were minor, 72 (25%) moderate, 16 (6%) severe, and 11 (4%) major according to the Modified Hand Injury Severity Score (MHISS). Men had a higher MHISS than women ( P < .01). Fracture was the most common injury among women, 97/287 (66%), and the mechanism was usually a fall. Wound was the most common among men, 69/141 (49%), inflicted by cut/saw/crush/avulsion. Men were younger than women at injury ( P < .01) and required more surgery ( P = .02) and more admissions ( P = .03). Thirty-six of two hundred eighty-six patients (13%) were healthy, while 78 of 286 (27%) patients took 5 or more medicines, mainly due to cardiovascular disease. Conclusions: We found an increased number of hand injuries over a 30-year period in combination with a decrease in patient-reported health treated at a hand surgery ward. Compared with younger patients, older men and women do not injure their hands as often. Men, at time of injury younger than women, sustain more wounds from hazardous equipment, thus, more severe injuries, while women usually fall and fracture their hands. Fall injury prevention seems to be most important to reduce the injuries among older women, while spreading of a safety philosophy might reduce the injuries among men. A minority of the elderly are healthy, which may complicate the treatment. Further studies regarding hand trauma in the elder population will be valuable for future prevention and rehabilitation of this patient group.