Evaluation of Pattern of Deep Wrist Injuries in Suicidal versus Accidental Cases Presenting in a Tertiary Care Hospital

Abstract: Background: The hand is the most dominant and important part of human body. Hand and wrist injuries are frequently associated with long-term pain, loss of productivity, disability and hence compromised quality of life. The primarily cause of wrist injuries are can be accidental or suicidal. Objective: to determine accidental and suicidal deep wrist injury (DWI) rate and compare patients’ anatomical features among the two injury types. Materials and Methods: This cross-sectional study was performed in Ruth Pfau Civil Hospital, DUHS during June to December, 2022. Patients visiting emergency rooms with acute hand injuries were enrolled into the study. The assigned data collectors’ participants’ features in a pre-designed structured proforma. Data was analyzed using SPSS version 26. Result: Total 384 patients were enrolled into the study with median age of 32 (IQR=25-45) years. Majority of victims were males (77.3%). Frequency of accidental injury was 82.6%. Out of 317 (82.6%) patients with accidental injury, common mechanism was road traffic accident (51%) followed by occupational injury (21.1%) and domestic violence (14.1%). None of the patients’ features were significantly different among accidental and suicidal injuries except marital status. Frequency of suicidal injury was significantly higher among married individuals than those who were single. Frequency of ulnar nerve (p=, flexor pollicis longus tendon (p= and flexor digitoram profundus (p=) was significantly higher in accidental cases than suicidal cases whereas ulnar artery (p=) and radial artery was significantly higher in suicidal cases. Conclusion: The current study found that almost one-fifth of DWI were suicidal attempts. Suicidal injuries were mainly damaging to radial and ulnar arteries where accidental injuries affected deep wrist structures such as ulnar nerve, flexor tendons and flexor digitoram profundus.