UC San Diego

PURPOSE: From 2018-2019, the height of over 400 miles of southern border wall was raised to 30 feet. Our aim was to evaluate the impact of the increase in border wall height on upper-extremity injuries sustained via barrier fall. METHODS: A retrospective review of patients admitted with upper-extremity injuries sustained via border wall fall between January 2015 and December 2022 at a Level 1 trauma center serving the United States-Mexico border. Patients admitted between 2015-2018 were included in the preincrease group, and those admitted between 2019-2022 were included in the postincrease group. Demographic data, injury severity metrics, fracture characteristics, operative treatments, hospital charges, and lengths of stay were compared. RESULTS: In total, 110 patients were identified, with 16 preincrease and 94 postincrease. Following the barrier height increase, patients had higher injury severity scores. Radial fractures were most common pre- and postincrease and accounted for nearly one-third of all fractures. Postincrease upper-extremity trauma patients required more operative events (2.15 ± 2.10 vs 1.44 ± 0.73 preincrease). The average cost for each patients hospital stay also quadrupled after the increase in wall height ($397,632 ± $1,057,574 vs $98,978 ± $84,169 preincrease). CONCLUSIONS: The increase in overall injury severity and costly inpatient treatment of upper-extremity injuries among patients who fell from the border following construction has placed additional stress on an already strained health care system. LEVEL OF EVIDENCE: Differential Diagnosis/Symptom Prevalence Study, IV.