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Outcomes and Complications in the Management of Distal Radial Fractures in the Elderly
- Source :
- The Journal of bone and joint surgery. American volume. 102(1)
- Publication Year :
- 2019
-
Abstract
- The purpose of the present study was to identify trends in management and to compare the outcomes and complications following nonoperative and operative management (including external fixation, closed reduction and percutaneous pinning, and open reduction and internal fixation) for distal radial fractures in patients ≥65 years of age.We performed a retrospective analysis, with use of the OptumLabs Data Warehouse database, of patients ≥65 years of age who had been managed for a distal radial fracture between 2009 and 2014 (as indicated by diagnosis codes according to the International Classification of Diseases, Ninth Revision, Clinical Modification). Ninety-day and 1-year complication rates per 1,000 fractures were analyzed overall and by treatment modality.Thirteen thousand, seven hundred and thirteen distal radial fractures were analyzed. The overall 90-day complication rate was 36.5 per 1,000 fractures, and the 1-year upper-extremity-specific complication rate was 236.2 and 307.5 per 1,000 fractures for nonoperative and operative management, respectively. Overall, post-injury stiffness was the most common 1-year upper-extremity-specific complication (incidence, 11.5%). There was no significant difference between operative and nonoperative management in terms of 90-day complication rates. However, operative management had a higher 1-year complication rate than nonoperative management (307.5 versus 236.2 per 1,000 fractures). Overall, the 5 most common upper-extremity-specific complications following operative treatment of distal radial fracture were stiffness (16.0%), chronic regional pain syndrome (9.9%), median neuropathy (8.0%), implant-related complications (3.8%), and tendon-related complications (2.8%). Stiffness was significantly more frequent following operative management (16.0% versus 9.8%; p0.01).Operative management of a distal radial fracture should be carefully considered when discussing treatment options with patients ≥65 years of age.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Radial fractures
03 medical and health sciences
External fixation
Fracture Fixation, Internal
0302 clinical medicine
Postoperative Complications
Fracture Fixation
Fracture fixation
medicine
Internal fixation
Humans
Orthopedics and Sports Medicine
030212 general & internal medicine
Range of Motion, Articular
Reduction (orthopedic surgery)
Device Removal
Aged
Retrospective Studies
Aged, 80 and over
030222 orthopedics
business.industry
Retrospective cohort study
General Medicine
Surgery
Percutaneous pinning
Multivariate Analysis
Female
Range of motion
business
Radius Fractures
Subjects
Details
- ISSN :
- 15351386
- Volume :
- 102
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The Journal of bone and joint surgery. American volume
- Accession number :
- edsair.doi.dedup.....44862586617a563a7b5f6cd3064b03d7