Hand fractures more common among male workers in SG

Young to middle-aged men who are skilled manual workers tend to be the ones who usually sustain hand fractures among the general population of Singapore, reports a study. The little finger ray and the distal phalanges are the most common ray and location of hand fractures, respectively.

“A better understanding of the epidemiology and distribution of hand fractures in Singapore can help identify individuals who are most at risk and potentially help to ascertain preventive measures,” the researchers said.

A review was conducted on a total of 701 hand fractures in 596 patients aged ≥21 years from a single centre from 2010 to 2011. The researchers then obtained details regarding patient demographics, occupation, mechanism of injury, associated injuries, and treatment.

Most hand fractures (58.9 percent) were noted among patients between the ages of 21 and 40 years, and males had a 5.5-fold greater relative risk than females. [Singapore Med J 2025;66:476-480]

Many hand fractures occurred at the workplace (47.7 percent), and the primary mechanism of injury was crush injury (33.6 percent). The most common locations were the little finger ray (31.2 percent) and distal phalanges (37.7 percent).

Surgical fixation was performed in 170 cases, accounting for 24.3 percent of all fractures. The rate of fixation was similar between closed and open fractures but was significantly higher in the proximal and middle phalanges than the distal phalanx and metacarpal (p<0.001).

Among the methods used for surgical fixation, the most frequently used were wires in either tuft fractures (100.0 percent) or intra-articular fractures (69.9 percent), as well as plates and screws in shaft fractures (65.5 percent).

Socioeconomic factors

“The results showed that socioeconomic factors such as occupation were an important predictor of hand fractures, with a high workplace accident rate of 47.7 percent,” the researchers said.

This is consistent with the findings of previous studies, which reported similar rates. [Ulus Travma Acil Cerrahi Derg 2012;18:49-54; J Forensic Medicine 2001;15:14-18; Am J Public Health 1994;84:657-660]

“Workplace accident was observed to be the most prevalent circumstance of injury among the working population, with the exception of office workers, who most commonly sustained hand fractures from road traffic accidents,” the researchers said.

The high rate of workplace accidents may be explained by the proximity to industrial areas. In addition, national service poses a potential occupational risk, with 26.9 percent of servicemen getting injured on duty. [Scand J Plast Reconstr Surg Hand Surg 1993;27:317-319; J Hand Surg Am 2011;36:278-283]

“The findings of this study should be interpreted in consideration of its limitations,” according to the researchers. [J Trauma 2010;69:699-707; J Hand Surg Eur Vol 2015;40:33-41]

First, the study was retrospective in design and used data from a single centre only. It also did not include the treatment outcome of patients in the analysis.

“Nevertheless, a reasonably large sample size was collected and analysed to give representative information about the epidemiology of hand fractures in Singapore,” the researchers said.