Background There are scarce data regarding the epidemiology of metacarpal fractures within the US population. The purpose of this study is to report the epidemiology of metacarpal fractures in the USA using the National Electronic Injury Surveillance System Database (NEISS). Methods The NEISS database represents a national probability sample of approximately 100 hospitals in the USA and its territories. The database was queried for metacarpal fractures during the time period 2002–2006. US census data were used to calculate incidence rate (IR) for various demographic criteria. Results A total of 4,718 metacarpal fractures were identified, representing approximately 160,790 metacarpal fractures. The calculated IR was 13.6 (95 % CI, 13.6–13.67) per 100,000 person-years. The highest IR occurred in the 10–19 age group (IR 38.8; 95 % CI, 38.6–38.9) followed by those 20–29 years of age (IR 28.4; 95 % CI, 28.3–28.5). Metacarpal fractures were found more commonly in males (IR 23; 95 % CI, 22.9–23.1) than females (IR 4.5; 95 % CI, 4.5–4.5), with an incidence rate ratio of 5.08. The most common mechanisms of injury were contact with a wall or door, and falls. The most common setting was in the home, followed by recreational locations. Conclusions The estimated incidence of metacarpal fractures presenting for acute hospital care in the USA is 13.6 per 100,000 person-years. Males in the second and third decades of life sustain this injury most commonly. Metacarpal fractures occur frequently in the home or recreational setting, with contact force as the primary mechanism of injury.
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