Statistics on Hand and Arm Loss

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Lilly Walters
Phone 909-398-1228, fax 408-228-8752

California
Who is Lilly Walters?

There were 1,285,000 persons in the U.S. living with the limb loss (excluding fingers and toes) in 1996. The prevalence rate in 1996 was 4.9 per 1,000 persons. The incidence rate was 46.2 per 100,000 persons with dysvascular disease, 5.86 per 100,000 persons secondary to trauma, 0.35 per 100,000 secondary to malignancy of a bone or joint. The birth prevalence of congenital limb deficiency in 1996 was 25.64 per 100,000 live births. The prevalence rate is highest among people aged 65 years and older ~ 19.4 per 1,000.

above from http://www.amputee-coalition.org/nllic_faq.html#2.


Numbers and percents on amputations

  • 50,000 new amputations every year in USA based on information from National Center for Health Statistics
  • ratio of upper limb to lower limb amputation is 1:4 (4)
  • most common is partial hand amputation with loss of 1 or more fingers, 61,000

  • next common is loss of one arm, 25,000

  • existence of 350,000 persons with amputations in USA, 30% have upper limb loss

  • of this, wrist and hand amputations are estimated to make up 10% of upper limb population

  • transradial amputations make up 60% of total wrist and hand amputations
  • which means 70% of all persons with upper limb amputations have amputations distal to the elbow(3)
  • In US 41,000 persons are registered who had an amputation of hand or complete arm (5)
  • 60% of arm amputations are between ages 21 and 64 years and 10% are under 21 years of age (4)

Causes leading to amputation

  • Reasons for amputation include cardiovascular disease, traumatic accidents, infection, tumors, nerve injury (trophic ulceration), and congenital anomalies (1)
  • most frequent causes of upper limb amputation are trauma and cancer, followed by vascular complications of disease
  • right arm more frequently involved in work related injuries
  • Congenital upper limb deficiency has an incidence of approximately 4.1 per 10000 live births (4)

Table 1 - Causes of Upper Extremity Amputation (in percent)

Congenital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.9%

Tumor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2%

Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8%

Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 77%

All above from http://biomed.brown.edu/Courses/BI108/BI108_2003_Groups/Hand_Prosthetics/stats.html

Who references the following

SOURCE: E. J. Davies, B R. Fnz, and F. W Cl!pplnger, “Amputees and Their Pros-theses,” Artificial Limbs 14(2) 19-48, 1970 (2)

only half of all upper extremity amputees ever receive prosthetic services

Poll of all manufacturers of terminal devices for prostheses revealed approximately 10,000 units sold per year (1)

30-50% of handicapped persons do not use prosthetic hand regularly(5)

References:

(1)http://cosmos.ot.buffalo.edu/t2rerc/programs/supplypush/devices.handt.htm

(2)http://www.wws.princeton.edu/cgi-bin/byteserv.prl/~ota/disk3/1984/8405/840504.PDF

(3)http://pubweb.acns.nwu.edu/~rfw586/papers/2000%20IEEE%20World% 20Congress%20-%20MO%20E325-4%20-%20Powered%20Fingers.pdf

(4)http://www.aapmr.org/zdocs/assembly/handouts/M116.pdf

(5)http://www.iai.fzk.de/medtech/fluid/literatur/icra_fzk_hand.pdf


Hand injuries and occupational accidents. Statistics and prevention]

Marty J, Porcher B, Autissier R.

Centre de Controle medical des accidents du travail, Paris.

Hand injuries count for a 1/3 of all injuries at work, 1/3 of chronic injuries, 1/4 of lost working time, 1/5 of permanent disability. This varies from activity to activity and with the material element involved. An average of 22 working days are lost, but this varies according to lesion. The average permanent rate is 5.8% against 10% for accidents in generally. High rates are not very frequent (2% above 10%). The average cost is between 12,000 F and 15,000 F (at 1980 rates) of which more than 2/3 can be attributed to daily compensations. In 1980, the number of finger amputations can be estimated at 11,000 (3300 fo which were accidents at work) whose overall cost was 140,000,000 F, the daily compensations being 2/3 of this figure. The cost of insuring this risk is subscribed by employers, and the contributions are based on the nature of the risk. To prevent accidents and the after effects certain points must obviously be stressed. The return of patients into working life is vital, even before complete recovery from their injuries.

PMID: 9382655 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9382655&dopt=Abstract

Over 3 million people in the USA have a disability in their hands and/or forearms, including paralyzations, orthopedic impairments, either congenital or injury related. (USA 1983-1986, from the Digest of Data on Person with Disabilitities, U.S. Department of Education, prepared January 1992)


About one in every 2000 new born babies will have some form of a limb deficiency; it may be absent parts of fingers or toes, complete absence of all four limbs or something in between. Another larger group of children lose limbs in accidents, especially to lawn mowers, trains, all terrain vehicles, and motorcycles; or to disease, including cancer. (reference "Faces of Adoption," "National Adoption Center," website)


About 120,000 babies (1 in 33) in the United States are born each year with birth defects

Source March of Dimes: marchofdimes.com

The severity of Poland's Syndrome differs from person to person and is often not diagnosed or reported. The incidence, therefore, is difficult to determine, but current estimates are between one in 10,000 to one in 100,000 births.

from http://www.polands-syndrome.com/


Amniotic Band Syndrome (ABS) affects approximately 1:1200 live births. It is also believed to be the cause of 178 in 10,000 miscarriages. Recent literature supports that ABS occurs more often than once thought. Up to 50% of cases have other congenital anomalies including cleft lip and palate and clubfoot deformity. Hand and finger anomalies occur in up to 80% of those with ABS.

from http://www.amnioticbandsyndrome.com/aboutABS.htm

From the 1990 US Census Bureau:

Among those 15 years old and over who had difficulty with a physical activity or an activity of daily living (ADL), ... stiffness or deformity of the foot, leg, arm, or hand (2.0 million) Disabilities mean a reduced chance for employment: The overall employment rate for persons 21 to 64 years old was 75.1 percent, but the rate varied by disability status. The employment rate was 80.5 percent among the 117.2 million persons with no disability, 76.0 percent among the 15.0 million persons with a nonsevere disability, and 23.2 percent among the 12.6 million persons with a severe disability. From a different perspective, the percent of all employed persons who had a disability was 13.4 percent (10.6 percent of employed persons had a nonsevere disability, and 2.8 percent had a severe disability).

Disability also had an impact on earnings. For workers 35 to 54 years old, the average amount earned in a month was $2,446 among those with no disability, $2,006 among those with a nonsevere disability, and $1,562 among those with a severe disability.


According to the LIMBS FOR LIFE FOUNDATION, "Every Week 2,996 People Lose a Limb."


A survey regarding extremity amputations & mental health issues conducted by Ron VanDerNoord, MD of the Frazier Rehab Center in cooperation with the Amputee Coalition of America provides the following insight into amputee rehabilitation.
- "75% of amputees said they needed more education than they were given from their medical professionals."

- "57% of amputees said they received NO educational materials."

- "Of the 43% who did receive materials, only 15-20% of the available materials were considered helpful."


These from the National Limb Loss Information Center with your inquiry about statistics. Currently, government agencies, like the Centers for Disease Control and the Census Bureau, do not classify disabilities as specifically as hand impairment. The most reliable statistics come from the Vital Health and Statistics National Health Interview Survey, 1996, administered by the Centers for Disease Control and Prevention. According to their estimates there were 26,000 people who had a surgical amputation of the upper extremity in 1996, and 23,000 who had a surgical amputation or disarticulation of the finger in 1996. There were 1,285,000 amputees (NOT amputations) recorded in 1996 in the US. Deformity or Orthopedic impairment of the upper extremity: 4,170,000 people had this impairment in 1996

The Disability Statistics Center at the University of California, San Francisco has a done a study on "Prevalence of Work Limitations Due to Chronic Conditions, Ages 18-69, 1992". The relevant statistics from that study are as follows:
Absence or loss of upper extremity: 66,000

Paralysis: 552,000

Quadriplegia: 40,000

Hemiplegia: 47,000

Paralysis of upper extremities: 26,000

Cerebral palsy: 100,000

http://www.amputee-coalition.org/llrsp/index.html

National Limb Loss Information Center 1-888-267-5669 ext. 8111

jbarnes@amputee-coalition.org


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