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

Abstract

Background: Distal radius fractures are the most common of all fractures. Optimal treatment is still debated. Previous studies report substantial changes in treatment trends in recent decades. Few nationwide studies on distal radius fracture epidemiology and treatment exist, none of which provide detailed data on patient and injury characteristics, fracture pattern and mortality. The aim of this study was to describe the epidemiology, fracture classification, current treatment regimens and mortality of distal radius fractures in adults within the context of a large national register study. Methods: We performed a descriptive study using prospectively registered data from the Swedish fracture register. Included were all non-pathological distal radius fractures registered between January 1st 2015 and December 31st 2017 in patients aged 18 years and above. Nominal variables were presented as proportions of all registered fractures. Results: A total of 23,394 distal radius fractures in 22,962 patients were identified. The mean age was 62.7 ± 17.6 years for all, 65.4 ± 16.0 for women and 53.6 ± 20.0 for men. A simple fall was the most common cause of injury (75%, n = 17,643/23,394). One third (33%, n = 7783/21,723) of all fractures occurred at the patients' residence. 65% (n = 15,178/23,394) of all fractures were classified as extra-articular AO-23-A, 12% (n = 2770/23,394) as partially intraarticular AO-23-B and 23% (n = 5446/23,394) as intra-articular AO-23-C. The primary treatment was non-surgical for 74% (n = 17,358/23,369) and surgical for 26% (n = 6011/23,369) of all fractures. Only 18% of the AO-23-A fractures were treated surgically, compared to 48% of the AO-23-C fractures. The most frequently used surgical method was plate fixation (82%, n = 4954/5972), followed by pin/wire fixation (8.2%, n = 490/5972), external fixation (4.8%, n = 289/5972) and other methods (4.0%, n = 239/5972). The overall 30-day mortality was 0.4% (n = 98/23,394) and the 1-year mortality 2.9% (n = 679/23,394). Conclusion: This nationwide observational study provides comprehensive data on the epidemiology, fracture classification and current treatment regimens of distal radius fractures in a western European setting. The most common patient was an eldery woman who sustained a distal radius fracture through a simple fall in her own residence, and whose fracture was extra-articluar and treated non-surgically.

Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients

“…The main surgical methods for distal radius fractures (DRFs) include open reduction with internal fixation (ORIF) using a volar plate (plate); closed reduction with percutaneous pinning (pins); and closed reduction with external fixation (EF). While a majority of all DRFs can be managed non-surgically, about 20% are treated surgically [1,2]. Recent studies have reported that the proportion of surgically managed fractures is increasing, and that the preferred surgical method has shifted from percutaneous techniques to ORIF over the last two decades [1][2][3][4][5][6][7].…”

Treatment and re-operation rates in one thousand and three hundred tibial fractures from the Swedish Fracture Register

“…The Swedish Fracture Register (SFR), on the other hand, prospectively collects data on all patients with all types of fracture, regardless of treatment [ 10 , 11 ]. Several validity and epidemiological studies based on data from the SFR have been published [ 1 , 12 – 21 ]. Register-based studies, such as studies based on data from the SFR, include all patients and fractures, regardless of treatment, and can describe the current treatment and results of the treatment algorithms being used in current clinical practice.…”

Epidemiology of Distal Radius Fractures in Children and Adults During the COVID-19 Pandemic – A Two-Center Study

“…Distal radius fractures constitute a social problem [1][2][3][4][5][6][7][8][9][10][11][12][13]. The COVID-19 pandemic has had a considerable impact on the lives of both adults and children around the world [13][14][15][16][17][18][19][20][21][22][23][24].…”

“…Distal radius fractures (DRFs) constitute 15-21% of all fractures and are the third most common location of osteoporosis-related fractures [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The estimated risk of DRF is 9-139/10,000 people per year [3,4,8,11,12].…”

“…The estimated risk of DRF is 9-139/10,000 people per year [3,4,8,11,12]. There are different DRF xation methods used in children and adults [2,6,7,9,10,11].…”