Wrist Ligament Surgeries: Nationwide Incidence in a 25-year Follow-Up.

Purpose: Wrist ligament surgeries are common procedures, but there is a lack of knowledge regarding their incidence and trends. This study is a retrospective registry study aimed at investigating nationwide incidence of wrist ligament surgeries from 1997 to 2021, in Finland. Methods: The data were retrieved from national electronic registry, the Finnish National Hospital Discharge Register. The primary outcome variable was the incidence of surgically treated wrist ligament tears per 100,000 person-years. Results: Our study detected a 23-fold increase in traumatic wrist ligament surgery incidence from 1997 to 2014 (from 0.48 to 11.4), followed by a steep decrease to one-third (from 11.4 to 4.0) between 2014 and 2021. The incidence of arthroscopic procedures was more than twofold compared to open procedures. In 2013, the incidence of arthroscopic procedures peaked, with arthroscopic procedures being performed more than four times as frequently as open ones. Conclusions: Our study has uncovered a notable increase in the incidence of wrist ligament surgeries, particularly in traumatic cases, over a 25-year period in Finland. This rise was prominent, and the trend continued until 2014, after which a decline was observed. A similar pattern was noted in the incidence of all arthroscopic ligament tear procedures, especially in the debridement of traumatic tears. The precise reasons for the observed rise and subsequent decline remain unknown, but factors such as advancements in imaging, equipment availability, development of surgical techniques, long and demanding learning curve for arthroscopic procedures, industry influences, scientific publications, and a larger proportion of young hand surgeons may have played a role. We believe that reporting operative trends, based on a reliable national registry, is valuable for enabling informed planning and resource allocation. However, further studies are needed to reveal the exact reasons behind these incidence changes and to evaluate the overall health care cost burden of these procedures. Type of study/level of evidence: Therapeutic IV.