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. 2019 Aug;8(4):305-311.
doi: 10.1055/s-0039-1685205. Epub 2019 Apr 16.

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

Ali Azad  1 , H Paco Kang  1 , Ram K Alluri  1 , Venus Vakhshori  1 , Harrison F Kay  1 , Alidad Ghiassi  1
Affiliations

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

Ali Azad et al. J Wrist Surg. 2019 Aug.

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.

Keywords: PearlDiver; age stratification; distal radius; elderly; epidemiology; pediatric.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Distal radius fracture distribution by age group.
Fig. 2
Fig. 2
Gender distribution in distal radius fractures by age group.
Fig. 3
Fig. 3
Annual trend in the use of open reduction internal fixation (ORIF) and closed reduction percutaneous fixation (percentage). There has been a linear increase in ORIF in the timeframe of the study ( r 2  = 0.98, p  < 0.0001) with a concomitant linear decrease in percutaneous pinning ( r 2  = 0.97, p <0.0001).
Fig. 4
Fig. 4
Annual trend in closed reduction percutaneous fixation ( A ) and open reduction internal fixation ( B ) by age group.
See this image and copyright information in PMC

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