Evolving Trends in Traumatic Hand Injury Diagnoses at a University Emergency Department-A 10-Year Analysis

Background: Hand trauma accounts for up to one-third of trauma-related emergency department (ED) visits and ranges from minor lacerations to complex multi-structural injuries. As healthcare systems, workflows, and patient behavior evolve, contemporary epidemiological data are crucial to guide triage, optimize resource allocation, and adapt patient care pathways. Methods: We performed a retrospective observational study of all hand-related ED consultations at a Swiss university hospital in 2013, 2016, 2019, and 2022. In total, 8644 cases were analyzed for demographics, diagnosis, anatomical localization, injury complexity (≥2 functional structures), seasonal distribution, and animal-related injuries. Temporal trends and demographic or clinical shifts were assessed using descriptive and inferential statistics. Results: Among 8644 cases, most patients were male (63.8%) with a median age of 38 years (IQR 26-55). Lacerations (32.2%) and blunt trauma (29.1%) were the most frequent diagnoses, primarily involving digits II-V. The proportion of complex injuries declined significantly from 40.0% in 2013 to 32.5% in 2022 (p < 0.001), while cat-bite injuries almost doubled from 1.3% in 2013 to 2.3% in 2022. Case volumes peaked in spring and early summer. Conclusions: Over the analyzed decade, hand trauma cases in the ED have shifted toward a rising proportion of minor, low-acuity conditions, possibly reflecting reduced primary care access and evolving referral patterns. These trends highlight the need for adaptive triage models, strengthened outpatient care, and structural responses to primary care shortages to ensure efficient resource use and maintain high-quality hand trauma management.