title: Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005.
abstract: 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.
authors: Community Health Research Center & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. yang.nanping@gmail.com
authors: Nan-Ping
authors: NP
authors: Yang
authors: Hou-Chaung
authors: HC
authors: Chen
authors: Dinh-Van
authors: DV
authors: Phan
authors: I-Liang
authors: IL
authors: Yu
authors: Yi-Hui
authors: YH
authors: Lee
authors: Chien-Lung
authors: CL
authors: Chan
authors: Pesus
authors: P
authors: Chou
authors: Jenn-Huei
authors: JH
authors: Renn
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic / Q000639:trends; D000208:Acute Disease; D000328:Adult; D003953:Diagnosis-Related Groups / Q000191:economics / Q000639:trends; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006306:Health Surveys / Q000379:methods* / Q000639:trends; D006801:Humans; D004204:Joint Dislocations / Q000191:economics / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000639:trends*; D009985:Orthopedics / Q000191:economics / Q000639:trends*; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology*; D055815:Young Adult