OTA 2008 Posters

Scientific Poster #119 Upper Extremity OTA-2008

The Incidence and Risk Factors for Scaphoid Fractures in a Young, Active Population

Jennifer M. Wolf, MD1 (a-Southwestern Orthopaedic Trauma Association);
Laura Dawson, DO2 (a-Southwestern Orthopaedic Trauma Association);
Sally Mountcastle, PhD2 (a-Southwestern Orthopaedic Trauma Association);
Brett D. Owens, MD2 (a-Southwestern Orthopaedic Trauma Association);
1University of Colorado, Denver, Colorado, USA;
2William Beaumont Army Medical Center, El Paso, Texas, USA

Purpose: The incidence of scaphoid fractures is not well known, having been previously studied in small populations only. An improved understanding of the rate of occurrence of scaphoid fractures and the related demographics and risk factors may help formulate diagnostic and preventive strategies.

Methods: The Defense Medical Epidemiology Database (DMED) compiles International Classification of Diseases (9th revision) and Clinical Modifications (ICD-9-CM) coding information for every patient encounter occurring in a U.S. military treatment facility, in addition to maintaining the demographic information on all active-duty U.S. soldiers. To determine the total number of scaphoid fractures, we queried the DMED system for ICD-9 code 814.01, fracture of the scaphoid, by race, gender, military service, rank, and age for the years 1998-2006. We used multivariate Poisson regression to calculate the rates and comparative rate ratios (RRs) of scaphoid fracture among the demographic groups, while controlling for covariates.

Results: A total of 14,704 scaphoid fractures were documented in our population at risk of 12,298,088 person-years. The unadjusted incidence rate of scaphoid fracture in our population was 1.20 fractures per 1000 person-years, with a 95% confidence interval (CI) from 1.18 to 1.21. Males had an incidence rate of 1.28 per 1000 person-years, while females had an incidence rate of 0.72 per 1000 person-years (RR = 1.79; 95% CI, 1.69-1.89). The highest incidence rate by age was seen in the 20- to 24-year-old age group, with incidence rates of 1.64 per 1000 person-years. The incidence rate for whites was 1.28, compared with blacks at 1.00 fractures per 1000 person-years (RR = 1.31; 95% CI, 1.26-1.37).

Conclusion and Significance: The incidence rate found in this study, 1.20 scaphoid fractures per 1,000 person years, is significantly higher than previous population studies. Male gender, younger age, and white race were significant demographic risk factors for injury. While young males have been previously observed anecdotally to have a higher rate of scaphoid fractures, this provides objective data of this group’s elevated risks. These differences in the rate of fracture may be a reflection of activity type and levels, which were not available for our study. Further evaluation of these specific populations at risk is warranted.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.