Epidemiology of distal radius fractures: a detailed survey on a large sample of patients in a suburban area

Abstract

Background: Literature lacks data on correlations between epidemiology and clinical data of patients with distal radius fractures (DRFs).

Aim: The aim of this study was to present a detailed epidemiologic survey of a large consecutive series of patient with DRFs.

Materials and methods: This retrospective study included 827 consecutive patients (579 females, 248 men) who sustained a DRFs in the last 5 years. All fractures were radiographically evaluated. DRFs were classified according to Association of Osteosynthesis classification. Data on age, gender, side, period in which fracture occurred, and fracture mechanism were collected. Statistical analysis was performed.

Results: The patients' mean age was 60.23 [standard deviation (SD) 16.65] years, with the left side being most frequently involved (56.1%). The mean age of females at the time of fracture was significantly higher than that of males. The most frequent pattern of fracture was the complete articular fracture (64.3%), while the most represented fracture type was 2R3A2.2 (21.5%). Regarding the period in which the fracture occurred, 305 DRFs (37.5%) were observed in the warmer months and 272 (33.4%) in the colder months. Low-energy trauma occurring outside home was found to be the major cause of DRF throughout the year. In both genders, trauma mechanism 2 was more frequent (59.4% F; 31.9% M; p < 0.01). A bimodal distribution of fracture mechanisms was found in males when considering the patient's age with a high-energy mechanism of fracture (3 and 4), identified in 21% (n = 52) of males aged 18-45 years, and a low-energy mechanism (1 and 2) was observed in 39.9% (n = 99) of males aged > 45 years. A significant correlation between all trauma mechanisms (from 1 to 6) and different fracture patterns (complete, partial, and extraarticular) was found (p value < 0.001). The mean age of patients with extraarticular fractures (mean age 61.75 years; SD 18.18 years) was higher than that of those with complete (mean age 59.84 years; SD 15.67 years) and partial fractures (mean age 55.26 years; SD 18.31 years). Furthermore, considering different fracture patterns and patient age groups, a statistically significant difference was found (p < 0.001).

Conclusions: DRFs have a higher prevalence in females, an increase in incidence with older age, and no seasonal predisposition. Low-energy trauma occurring at home is the main cause of fracture among younger males sustaining fractures after sports trauma; Complete articular is the most frequent fracture pattern, while 2R3A2.2 is most frequent fracture type.

Level of evidence: Level IV; case series; descriptive epidemiology study.

Keywords: AO classification; Distal forearm fractures; Distal radius fractures epidemiology; Distal radius fractures trauma mechanisms; Isolated distal radius fractures.

Fig. 1

Yearly distribution of DRFs in both genders according to a 2-month classification period. DRFs, distal radius fractures

Fig. 2

Yearly distribution of DRFs according to trauma mechanism in a 2-month classification period. DRFs, distal radius fractures. I, low-energy trauma that occurred in a public place; II, low-energy trauma that occurred at home; III, sports trauma; IV, high-energy trauma resulting from car and pedestrian accident; V, work-related injuries; VI, trauma resulting from assault, beatings, or theft

Fig. 3

Distribution of DRFs in both genders according to the different trauma mechanisms. M, male; F, female. DRFs, distal radius fractures; Mec 1, low-energy trauma that occurred in a public place; Mec 2, low-energy trauma that occurred at home; Mec 3, sports trauma; Mec 4, high-energy trauma resulting from car and pedestrian accident; Mec 5, work-related injuries; Mec 6, trauma resulting from assault, beatings, or theft

Fig. 4

Distribution of trauma mechanisms according to the days of the week. I, low-energy trauma that occurred in a public place; II, low-energy trauma that occurred at home; III, sports trauma; IV, high-energy trauma resulting from car and pedestrian accident; V, work-related injuries; VI, trauma resulting from assault, beatings, or theft

Fig. 5

Distribution of DRFs patterns according to gender. M, male; F, female; DRFs, distal radius fractures

Fig. 6

Distribution of extraarticular patterns of DRFs according to gender. M, male; F, female; DRFs, distal radius fractures

Fig. 7

Distribution of partial-articular patterns of DRFs according to gender. M, male; F, female. DRFs, distal radius fractures

Fig. 8

Distribution of articular patterns of DRFs according to gender. M, male; F, female; DRFs, distal radius fractures