Analysis of epidemiology, etiology and injury patterns in 2,179 digit amputations

As digit amputations can profoundly affect hand function and quality of life, insight into their anatomical distribution, etiology, and epidemiology is fundamental to improving treatment and prevention. This retrospective study investigates 2,179 digit amputations in 1,768 patients treated between April 2005 and December 2021 at a German Level I trauma center, excluding successful replantations. The cohort was predominantly male (89.1%) with a median age of 49 years (IQR: 34-61) and age peaks at 20-30 and 40-60 years. Occupational injuries accounted for 38.7% of cases, more frequent among males and those under 40. Temporal trends showed seasonal peaks in July and September and increased incidence on Fridays and Saturdays. Sharp injuries were the leading cause, followed by blunt trauma and avulsion. The index finger was most frequently affected, with the distal interphalangeal joint being the most common amputation level among Long fingers. Multiple digit amputations occurred in 17.5% of cases and predominantly in patients suffering from leisure trauma. This study provides a detailed epidemiological and etiological analysis of digit amputations, revealing a young, male-dominated cohort with a significant proportion of occupational trauma. The findings highlight the need for targeted prevention strategies and informed planning of trauma care resources.