Epidemiology and changed surgical treatment methods for fractures of the distal radius

Abstract

Background and purpose The incidence of fractures of the distal radius may have changed over the last decade, and operative treatment has been commoner during that time. We investigated the incidence of fractures of the distal radius and changing trends in surgical treatment during the period 2004–2010.Patients and methods Registry data on 42,583 patients with a fracture of the distal radius from 2004 to 2010 were evaluated regarding diagnosis, age, sex, and surgical treatment.Results The crude incidence rate was 31 per 104 person-years with a bimodal distribution. After the age of 45 years, the incidence rate in women increased rapidly and leveled off first at a very high age. The incidence rate in postmenopausal women was lower than previously reported. In men, the incidence was low and it increased slowly until the age of 80 years, when it amounted to 31 per 104 person-years. The number of surgical procedures increased by more than 40% despite the fact that there was reduced incidence during the study period. In patients ≥ 18 years of age, the proportion of fractures treated with plating increased from 16% to 70% while the use of external fixation decreased by about the same amount.Interpretation The incidence rate of distal radius fractures in postmenopausal women appears to have decreased over the last few decades. There has been a shift in surgical treatment from external fixation to open reduction and plating.

The operative treatment of fractures of the distal radius is increasing

“…They report that the increase in plating was most marked in the higher age groups, which is in accordance with the findings in this study. In the Stockholm area, operations for fractures of the distal radius increased between 2004 and 2010, 23 which is also in accordance with our findings. Fanuele et al 24 reported a similar increasing trend for plating in the United States.…”

“…Despite the lack of unanimous evidence for the benefit of volar plating, 21 this increase has been reported from several countries. 17,22,23 A recent Finnish epidemiological study showed that the incidence of plating of fractures of the radius doubled in Finland between the years 2006 and 2008. 17 They reported an incidence rate of 4.72 per 10 000 person-years for operative treatment of a fracture of the distal radius in 2008.…”

“…34 The incidence rates in our study are similar to those reported by other recent epidemiological studies from Scandinavia. 23,30,32 The extent of osteoporosis in the population is considerable, and pharmacological prophylaxis has been used. 35 It is possible that the effect of such medication might be reflected in the slight decrease in the incidence of fractures of the distal radius reported at the start of the 21st century, but this is not supported by the current literature.…”

Wrist malpractice claims in Northern Norway 2005–2014. Lessons to be learned

“…In Norway, the age and gender adjusted rate during the period 2009–2014 was 244 wrist fractures per 100,000 inhabitants [21]. This is in accordance with Swedish and Finish figures [22,23]. …”

Distal Radial Fractures in Older Men

“…Recent data show that men and women experience peak rates of distal radial fracture between fifty and sixtyfour years, with women continuing to experience high rates of fracture until the eighth decade 39 . This likely accounts for the younger age of our male population at the time of fracture.…”