ABSTRACT
INTRODUCTION: Fractures of the lower trunk are among the most common fractures occurring in the elderly. Super elderly individuals (i.e., those 80 years of age and older) represent a growing segment of the population and are especially prone to these fractures. The contemporary epidemiology of lower trunk fractures in the super elderly population is incompletely described in the literature. MATERIALS AND METHODS: This descriptive epidemiology study used the National Electronic Injury Surveillance System (NEISS) to examine the incidence and recent trends of lower trunk fractures (i.e., fractures of the hip, pelvis, and lumbar spine) occurring among super elderly individuals in the United States (US) from 2011 to 2020. Annual, overall, and age-/sex-specific incidence rates (IRs) were analyzed. Average annual percent change (AAPC) estimates were calculated to indicate the magnitude/direction of trends in annual injury rates. RESULTS: An estimated N=1,226,160 super elderly patients sustained lower trunk fractures over the 10-year study period for an overall IR of 100.2 per 10,000 person-years at-risk (PYR). Hip fractures accounted for the largest percentage of cases (IR=71.7 PYR), followed by lumbar spine fractures (IR=14.7), and pelvic fractures (IR=14.3). The incidence of lower trunk fractures among super elderly females (IR=121.5 PYR) was significantly greater than that of males (IR=65.7 PYR). The incidence of lower trunk fractures among nonagenarians and centenarians was significantly higher than that of octogenarians. Accounting for population growth yielded a significantly increasing annual incidence of lower trunk fractures in super elderly patients over the study period from 86.7 PYR in 2011 to 107.2 PYR in 2020 (AAPC=2.7, p<0.001). The annual incidence of both pelvic (AAPC=5.8) and lumbar spine (AAPC=6.9) fractures increased at a significantly higher rate than that of hip fractures (AAPC=1.4). CONCLUSIONS: This study suggests that the annual incidence of lower trunk fractures in the oldest cohort of patients in the US (80+ years of age) increased significantly during the recent decade from 2011 to 2020, with pelvic and lumbar fractures in particular becoming increasingly common. Increased incidence rates highlight the need for future research aimed at optimizing outcomes and quality of life in this frail and ever-growing segment of the population.
ABSTRACT
INTRODUCTION: Hoverboards are a popular means of recreation in the United States and are associated with significant injury risk, leading to recent efforts to improve their safety. Prior studies on hoverboard-related injuries were either conducted prior to implementation of safety regulations, consisted of short study intervals, or did not place a focus on injuries as they pertain to the orthopedic specialist. The purpose of this study is to provide an updated assessment of the epidemiology of orthopedic hoverboard-related injuries presenting to US emergency departments. MATERIALS AND METHODS: A retrospective analysis from 2015 to 2022 of the National Electronic Injury Surveillance System (NEISS) database was conducted, limited to product codes detailing hoverboard-related injuries leading to emergency department visits. Diagnoses of interest included fractures, dislocations, contusions/abrasions, and strains/sprains. Diagnoses were further broken down to analyze anatomic region affected. National estimates (NE) were calculated using survey methods. One-way ANOVA and chi square tests were used to test for changes over time in injuries, age, and gender. RESULTS: 4,718 total hoverboard-related injuries were captured, with a national estimate of 154,121. The majority of patients were under 18 years old (79.6 %; P < 0.001) and female (52.5 %; P = 0.038). Orthopedic injuries accounted for 68.6 % of the total, with no significant year-by-year change in this proportion (P = 0.069). Fractures were the most common orthopedic injury (64.2 %), followed by contusions/abrasions (20.2 %), strains/sprains (14.6 %), and dislocations (1.0 %). Most fractures affected the forearm (33.8 %) followed by the wrist (29.2 %). Injuries peaked in 2018 (NE = 25,192) and 2020 (NE = 24,958), followed by a decline in incidence more recently. CONCLUSION: Hoverboard-related injuries continue to be a common presentation to US emergency departments, though injury rates appear to be decreasing. Orthopedic injuries consistently account for the majority of hoverboard-related injuries reporting to emergency departments, with fractures of the forearm and wrist being most common. Continued efforts toward improving safety measures regarding hoverboard use are warranted.