Epidemiologic Patterns of Musculoskeletal Disorders by Body Region Across 1.2 Million Orthopedic Visits: A 15-Year Experience From a Middle-Income Country

Abstract

Background

Musculoskeletal problems occupy an important place among outpatient clinical applications. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), has facilitated the understanding of disease diagnoses in a common language worldwide and the processing of data. However, studies examining all orthopedic diagnoses in a large population are limited. In this study, we analyzed over 1.2 million ICD-10-coded orthopedic visits over 15 years in a secondary-level hospital located in a low-income, working-class district of Türkiye, providing a regional diagnostic overview and a basis for global comparison.

Methods

The distribution of 1,242,058 applications to the orthopedics and traumatology polyclinic of a regional hospital serving a population of approximately 500,000 between 01 January, 2010, and 31 December, 2024, was according to body parts based on ICD-10 diagnosis codes. Trauma- and nontrauma-related diagnoses were also evaluated.

Results

Of the total applications, 43.8% were trauma-related. Sprain and strain of the ankle, fracture of the lower end of the radius, and sprain and strain of the wrist were the most common diagnoses. In terms of sex, there was a 60.7% female predominance in the distribution of the applications. Further, 996,011 applications included an expression wherein the anatomical region in the ICD-10 diagnosis code was specified. The most common diagnosis among the nontrauma-related cases was primary gonarthrosis. The most common regions in the upper extremities for which diagnoses were recorded were the hands and wrists. On the other hand, the most common regions in the lower extremities for which diagnoses were recorded were the knees, feet, and ankles. The most common diagnosis involving the spine was low back pain.

Conclusions

In the context of musculoskeletal disorders, which occupy a large part of the outpatient health services, it is important to know the number of diagnoses and their regional distribution to estimate the level of need for health services and determine the necessary number of healthcare personnel, service buildings, and examination devices. Understanding the prevalence of these diseases will help determine the curriculum for training orthopedic and traumatology assistants. Our findings may also serve as a reference point for musculoskeletal health planning in similar low- to middle-income settings.