Two Thumbs Down: A 10-Year Analysis of Crossbow-Related Hand and Digit Injuries in the United States

Hand (N Y). 2024 Oct;19(7):1102-1108. doi: 10.1177/15589447231167579. Epub 2023 Apr 28.

Abstract

Background: Modern crossbow is a popular weapon used throughout the United States for outdoor recreation. Crossbow mechanics place the hand and digits at significant risk of injury while shooting or handling these weapons; however, injury patterns have been poorly documented. In this study, the authors use a national database to assess patterns of crossbow-related injuries of the hand and digits.

Methods: A retrospective review of the National Electronic Injury Surveillance System database was conducted to identify crossbow-related hand and digit injuries over the past 10 years. Demographic data, injury timing, anatomical injury location, specific injury diagnosis, and disposition data were collected.

Results: A total of 15 460 crossbow-related hand injuries were identified between 2011 and 2021. A strong temporal relationship was identified, with 89% of injuries occurring between the months of August and December. Male patients sustained most injuries (>85%). Body areas injured were the digits (93.2%) and the hand (5.7%). The most common injuries were laceration (n = 7520, 48.6%), fracture (n = 4442, 28.7%), amputation (n = 1341, 8.7%), and contusion/abrasion (n = 957, 6.2%). More than 50% of cases involved injury to the thumb, with approximately 750 thumb amputations recorded during the time period examined.

Conclusions: This study is the first to document the patterns of hand and digit injuries associated with crossbow use on a national scale. These findings have important implications for public health awareness campaigns targeting hunters and support the designation of crossbow "safety wings" as a mandatory feature of crossbow design.

Keywords: crossbow amputation; crossbow hand injury; crossbow thumb injury; distal thumb injury.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amputation, Traumatic / epidemiology
  • Amputation, Traumatic / etiology
  • Child
  • Child, Preschool
  • Contusions / epidemiology
  • Databases, Factual
  • Female
  • Finger Injuries* / epidemiology
  • Finger Injuries* / etiology
  • Fractures, Bone / epidemiology
  • Hand Injuries* / epidemiology
  • Hand Injuries* / etiology
  • Humans
  • Lacerations* / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Distribution
  • United States / epidemiology
  • Weapons / statistics & numerical data
  • Young Adult