Global, regional, and national burden of congenital musculoskeletal and limb anomalies, 1990-2021: A systematic analysis of the global burden of disease in 2021

Background Congenital musculoskeletal and limb anomalies represent a rare and complex condition globally, with multifactorial etiology. Limited research has been conducted on the incidence trends of these anomalies. This study aims to investigate the patterns and temporal trends of congenital musculoskeletal and limb anomalies. Methods Detailed data on congenital musculoskeletal and limb anomalies from 1990 to 2021 were sourced from the 2021 Global Burden of Disease Study, stratified by sex, region, and country, and integrated with the Socio-demographic Index (SDI). To quantify the burden of these anomalies, we utilized Age-Standardized Incidence Rates (ASIR), Age-Standardized Mortality Rates (ASMR), Age-Standardized Prevalence Rates (ASPR), and Estimated Annual Percentage Change (EAPC). Additionally, decomposition analysis was conducted to examine the impact of aging, population, and epidemiological change on the burden. The ARIMA model was employed to forecast the burden for the period 2021–2031, while health inequality was assessed using the Slope Index of Inequality and the Concentration Index. Results Brunei Darussalam recorded the highest age-standardized incidence rate (ASIR) for congenital musculoskeletal and limb anomalies globally in 2021, followed by Republic of Guatemala and Argentine Republic. Afghanistan and United Mexican States had the highest mortality and prevalence rates, respectively. India reported the largest number of cases and deaths in absolute terms, while China had the highest number of cases. The ARIMA model forecasts that by 2031, the number of congenital musculoskeletal and limb anomalies will increase from 2,437,890 to 24,711,128, while the number of deaths is projected to decrease from 13,600 to 10,137. The patient population is expected to grow from 18,549,408 to 19,207,414. Decomposition analysis revealed that the rise in the number of congenital musculoskeletal and limb anomalies in moderate SDI regions was primarily driven by population growth, whereas the reduction in mortality was mainly attributed to epidemiological changes and aging. In low and medium SDI areas, both population and epidemiological changes contributed to the increase in case numbers. The EAPC exhibited a significant correlation with ASIR and ASMR. Between 1990 and 2021, inequalities in the incidence and mortality of congenital musculoskeletal and limb anomalies have significantly increased. Lower SDI regions have experienced concentrated incidence and mortality, with respective inequities on the rise. The concentration index for incidence rose from 0.28 in 1990 to 0.35 in 2021, and the concentration index for mortality increased from 0.34 in 1990 to 0.42 in 2021, indicating an escalating burden of congenital musculoskeletal and limb anomalies in lower SDI groups. Conclusion This study estimated temporal trends in the incidence and mortality of Congenital musculoskeletal and limb anomalies from 1990 to 2021 at the global, national, and regional levels. Adverse trends were observed in countries with lower sociodemographic indices. This suggests that some countries should develop more targeted and specific strategies to address the burden of Congenital musculoskeletal and limb anomalies.