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. 2019 Jul;14(4):534-539.
doi: 10.1177/1558944717751194. Epub 2018 Feb 1.

Treatment Trends, Complications, and Effects of Comorbidities on Distal Radius Fractures

William P Mosenthal  1 , Haroutioun H Boyajian  1 , Sandra A Ham  1 , Megan A Conti Mica  1
Affiliations

Treatment Trends, Complications, and Effects of Comorbidities on Distal Radius Fractures

William P Mosenthal et al. Hand (N Y). 2019 Jul.

Abstract

Background: Distal radius fractures (DRFs) are the most common upper extremity fractures in adults. This study seeks to elucidate the impact age, fracture type, and patient comorbidities have on the current treatment of DRFs and risk of complications. We hypothesized that comorbidities rather than age would relate to the risk of complications in the treatment of DRFs. Methods: A retrospective review of data was performed for patients treated between 2007 and 2014 using Truven Health MarketScan Research Databases. Patients who sustained a DRF were separated into "closed" versus "open" treatment groups, and the association between patient demographics, treatment type, and comorbidities with complication rates was analyzed, along with the trend of treatment modalities throughout the study time interval. Results: In total, 155 353 DRFs were identified; closed treatment predominated in all age groups with the highest percentage of open treatment occurring in the 50- to 59-year age group. Between 2007 and 2014, there was an increase in the rate of open reduction and internal fixation (ORIF) in all age groups <90 with the largest increase (11%) occurring in the 70- to 79-year age group. Higher complication rates were observed in the open treatment group in all ages <90 years with a trend toward decreasing complication rates as age increased. Comorbidities were more strongly associated with the risk of developing complications than age. Conclusions: Closed treatment of DRFs remains the predominant treatment method among all age groups, but DRFs are increasingly being treated with ORIF. Emphasis on the patients' comorbidities rather than chronological age should be considered in the treatment decision-making process of elderly patients with DRFs.

Keywords: age; closed; comorbidities; complications; distal radius; fracture; open; treatment.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Change in distal radius fracture treatment type by age group between 2007 and 2014. Note. ORIF = open reduction and internal fixation.
Figure 2.
Figure 2.
Percentage of nonclosed treatment of DRFs between 2007 and 2014. Note. Current Procedural Terminology codes: 25606: percutaenous fixation of DRF, 25607: open treatment of extra-articular DRF, 25608: open treatment of intra-articular DRF with internal fixation of 2 fragments, and 25609: open treatment of intra-articular DRF with internal fixation of 3 or more fragments. DRF = distal radius fracture.
Figure 3.
Figure 3.
Complication rate between closed and open treatment.
Figure 4.
Figure 4.
Unadjusted mean incidence of complications and comorbidities by age group. Note. HTN = hypertension; CHF = chronic heart failure; CKD = chronic kidney disease.
See this image and copyright information in PMC

References

    1. Arias E. United States Life Tables, 2010. National Vital Statistics Reports. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. - PubMed
    1. Arora R, Lutz M, Deml C, et al. A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am. 2011;93:2146-2153. - PubMed
    1. Bartl C, Stengel D, Bruckner T, et al. The treatment of displaced intra-articular distal radius fractures in elderly patients. Dtsch Arztebl Int. 2014;111:779-787. - PMC - PubMed
    1. Barton T, Chambers C, Bannister G. A comparison between subjective outcome score and moderate radial shortening following a fractured distal radius in patients of mean age 69 years. J Hand Surg Eur Vol. 2007;32:165-169. - PubMed
    1. Case AJ, Zimmerman MC. Sympathetic-mediated activation versus suppression of the immune system: consequences for hypertension. J Physiol. 2016;594:527-536. - PMC - PubMed

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