Orthopaedic trauma in the Anabaptist community: epidemiology and hospital charges

This study aims to define the epidemiology of orthopaedic trauma in the rural Anabaptist community and analyze the hospital charges associated with their treatment. The authors performed a retrospective review of 79 Amish and 40 Mennonite patients who had been seen in their rural level I trauma center emergency department for an orthopaedic injury from January 2006 to May 2013. Data collection included baseline demographics, injury mechanism and severity, injury complex, operative interventions, outcomes, and hospital charges. Amish and Mennonite groups were similar except for a higher percentage of males in the Mennonite group. For Amish patients, occupational injuries (52%) and buggy accidents (16%) accounted for the highest percentage of admissions. Eighty-seven percent sustained at least one fracture, most commonly of the hand (11%). Amish patients were statistically more likely to sustain fractures of the spine, and Mennonite patients were more likely to sustain fractures of the foot and femur. Over half of patients required surgery (58%). Total hospital charges did not differ based between the groups. Amish patients completed outpatient follow-up less frequently than Mennonite patients. Anabaptist patients are at risk for a variety of orthopaedic injuries related to their unique lifestyle and vocations. Socioreligious beliefs must be taken into consideration when educating these patients regarding postinjury care, as attendance at outpatient follow-up is low. Understanding the types of injuries that these patients sustain can help create strategies to prevent costly transportation and agricultural accidents within the Anabaptist community.