Epidemiological and Treatment Trends of Distal Radius Fractures across Multiple Age Groups

Abstract

Background The purpose of this study is to assess the epidemiology, population-specific treatment trends, and complications of distal radius fractures in the United States. Methods The PearlDiver database (Humana [2007–2014], Medicare [2005–2014]) was used to access US inpatient and outpatient data for all patients who had undergone operative and nonoperative treatment for a distal radius fracture in the United States. Epidemiologic analysis was performed followed by age-based stratification, to assess prevalence, treatment trends, and rates of complications. Results A total of 1,124,060 distal radius treatment claims were captured. The incidence of distal radius fractures follows a bimodal distribution with distinct peaks in the pediatric and elderly population. Fractures in the pediatric population occurred predominately in males, whereas fractures in the elderly population occurred more frequently in females. The most commonly used modality of treatment was nonoperative; however, the use of internal fixation increased significantly during the study period, from 8.75 to 20.02%, with a corresponding decrease in percutaneous fixation. The overall complication rate was 8.3%, with mechanical symptoms most frequently reported. Conclusions The last decade has seen a significant increase in the use of internal fixation as treatment modality for distal radius fractures. The impetus for this change is likely multifactorial and partly related to recent innovations including volar locking plates and an increasingly active elderly population. The implicated financial cost must be weighed against the productivity cost of maintaining independent living to determine the true burden to the healthcare system.

Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register

“…Of all DRFs treated surgically as the primary treatment, more than four out of five underwent internal plate fixation. This is in accordance with previous studies, which have reported that plate fixation has become the predominantly preferred surgical method in recent years in several countries [4,11,18,29,30].…”

“…Distal radius fractures (DRFs) are the most common orthopaedic fractures in the western world [1]. The distribution of DRFs in the general population is bimodal with incidence peaks in young men and in postmenopausal women [1][2][3][4]. DRFs in younger patients with good bone stock are most commonly associated with high-energy trauma [5], while low-energy trauma, e.g.…”

“…Previous studies have high-lighted major changes in the treatment regimens of DRFs in the past two decades. Not only has the overall rate of surgically managed fractures increased, there has also been a significant increase in the use of internal plate fixation and a concomitant decrease in the use of percutaneous methods [4,11].…”

“…Only a few nation-wide register studies of DRF epidemiology and treatment exist in the literature, and while they provide detailed description of incidence and changing treatment trends in recent years [4,11,17,18], they lack comprehensive data on fracture pattern, injury characteristics and mortality.…”

Radiographic Analysis in Reduction Loss After Distal Radius Fracture Fixation with Variable Angle Volar Locking Plate

“…Distal radial fracture is a very common injury, which has shown a bimodal distribution of age-speci c incidence with an increasing prevalence in adults and aging people [1][2][3]. Non-surgical treatment is generally adopted for non-or minimally displaced fractures.…”