Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005

BMC Musculoskeletal Disorders

Jenn-Huei Renn⁶  Pesus Chou⁵  Chien-Lung Chan⁴  Yi-Hui Lee¹  I-Liang Yu⁴  Dinh-Van Phan⁴  Hou-Chaung Chen²  Nan-Ping Yang³ 

[1] Department of Nursing, School of Nursing, Chang-Gang University, Taoyuan, Taiwan;Department of Orthopedics, Tai-Chung General Hospital, Department of Health, Taichung, Taiwan;Department of Orthopedics & Department of Medical Research, Tao-Yuan General Hospital, Department of Health, Taoyuan, Taiwan;Department of Information Management, Yuan-Ze University, Taoyuan, Taiwan;Community Health Research Center & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan;Department of Orthopedics, Kaohsiung Veterans General Hospital, Executives Yuan, Kaohsiung, Taiwan

关键词: orthopedic dislocation;    incidence;   

Others  :  1151323
DOI  :  10.1186/1471-2474-12-253

 received in 2011-02-13, accepted in 2011-11-05,  发布年份 2011

【 摘 要 】

Background

The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population.

Methods

A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major categories, respectively. The cases matching both inclusive criteria of dislocation-related diagnosis codes and treatment codes were defined as incident cases.

Results

During 2000-2005, the estimated annual incidence (per 100,000 population) of total orthopedic dislocations in Taiwan was 42.1 (95%CI: 38.1-46.1). The major cause of these orthopedic dislocations was traffic accidents (57.4%), followed by accident falls (27.5%). The annual incidence dislocation by location was shoulder, 15.3; elbow, 7.7; wrist, 3.5; finger, 4.6; hip, 5.2; knee, 1.4; ankle, 2.0; and foot, 2.4. Approximately 16% of shoulder dislocations occurred with other concomitant fractures, compared with 17%, 53%, 16%, 76% and 52%, respectively, of dislocated elbow, wrist, hip, knee, and ankle cases. Including both simple and complex dislocated cases, the mean medical cost was US$612 for treatment of a shoulder dislocation, $504 for the elbow, $1,232 for the wrist, $1,103 for the hip, $1,888 for the knee, and $1,248 for the ankle.

Conclusions

In Taiwan, three-quarters of all orthopedic dislocations were of the upper limbs. The most common complex fracture-dislocation was of the knee, followed by the wrist and the ankle. Those usually needed a treatment combined with open reduction of fractures and resulted in a higher direct medical expenditure.

【 授权许可】

   
2011 Yang et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Mock C, Cherian MN: The global burden of musculoskeletal injuries: challenges and solutions. Clin Orthop Relat Res 2008, 466:2306-2316.
• [2]Lopez AD, Mathers CD, Ezzati M, et al.: Global and regional burden of disease and risk factors. New York: Oxford University Press; 2006.
• [3]Krug EG, Sharma GK, Lozano R: The global burden of injuries. Am J Public Health 2000, 90:523-526.
• [4]WHO: The injury chart book: a graphical overview of the global burden of injuries. Geneva: World Health Organization; 2002.
• [5]Yang NP, Lee YH, Lin CH, Chung YC, Chen WJ, Chou P: Utilization of and direct expenditure for emergency medical care in Taiwan: a population-based descriptive study. J Epidemiol 2009, 19:41-48.
• [6]Yang NP, Chan CL, Yu IL, Lee CY, Chou P: Estimated Prevalence of Orthopedic Fractures in Taiwan - A Cross-sectional Study based on Nationwide Insurance Data. Injury 2010, 41:1266-1272.
• [7]Wen CP, Tsai SP, Chung WS: A 10-year experience with universal health insurance in Taiwan: measuring changes in health and health disparity. Ann Intern Med 2008, 148:258-267.
• [8]Lee YC, Huang YT, Tsai YW, Huang SM, Kuo KN, McKee M, Nolte E: The impact of universal National Health Insurance on population health: the experience of Taiwan. BMC Health Serv Res 2010, 10:225. BioMed Central Full Text
• [9]Brinker MR, O'Connor DP: The incidence of fractures and dislocations referred for orthopaedic services in a capitated population. J Bone Joint Surg Am 2004, 86:290-297.
• [10]Simonet WT, Melton LJ, Cofield RH, Ilstrup DM: Incidence of anterior dislocation in Olmsted County, Minnesota. Clin Orthop Relat Res 1984, 186:186-191.
• [11]Zacchilli MA, Owens BD: Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am 2010, 92:542-549.
• [12]Sherman SC, Schaider J: Shoulder dislocation and reduction. [http://hppt://www.uptodate.com/constents/shoulder-dislocation-and-reduction] webcite This topic last updated: Oct. 6, 2010
• [13]Amadio PC: Epidemiology of hand and wrist injuries in sports. Hand Clin 1990, 6:379-381.
• [14]Yuan L, Shih C: Dislocation after total hip arthroplasty. Arch Orthop Trauma Surg 1999, 119:263-266.
• [15]Fong DT, Hong Y, Chan LK, Yung PS, Chan KM: A systematic review on ankle injury and ankle sprain in sports. Sports Med 2007, 37:73-94.
• [16]Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ Jr: The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am 2010, 92:2279-2284.
• [17]Spiegel DA, Gosselin RA, Coughlin RR, Kushner AL, Bickler SB: Topics in global public health. Clin Orthop Relat Res 2008, 466:2377-2384.
• [18]Polinder S, Meerding WJ, van Baar ME, Toet H, Mulder S, van Beeck EF, EUROCOST Reference Group: Cost estimation of injury-related hospital admissions in 10 European countries. J Trauma 2005, 59:1283-1290.