TY - JOUR
T1 - Outcomes and complications of operative versus non-operative management of distal radius fractures in adults under 65 years of age
AU - DeGeorge, Brent R.
AU - Van Houten, Holly K.
AU - Mwangi, Raphael
AU - R Sangaralingham, Lindsey
AU - Kakar, Sanjeev
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2021/2
Y1 - 2021/2
N2 - To compare the outcomes of non-operative versus operative treatment for distal radius fractures in patients aged from 18 to 64 years, we performed a retrospective analysis using the OptumLabs® Data Warehouse using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes of distal radius fracture. Of the 34,184 distal radius fractures analysed, 11,731 (34%) underwent operative management. Short-term complications within 90 days of fracture identified an overall complication rate of 16.6 per 1000 fractures and the 1-year upper extremity-specific complication rate was 287 per 1000 fractures. Overall, post-injury stiffness was the most common 1-year upper extremity-specific complication and was associated with operative management (202.8 vs. 123.4 per 1000 fractures, operative vs. non-operative, p < 0.01). Secondary procedures were significantly more common following non-operative management (8.7% vs. 43%, operative vs. non-operative, p < 0.01) with carpal tunnel release representing the most common secondary procedure. Operative management of distal radius fractures resulted in significantly fewer secondary procedures at the expense of increased overall 1-year complication rates, specifically stiffness.
AB - To compare the outcomes of non-operative versus operative treatment for distal radius fractures in patients aged from 18 to 64 years, we performed a retrospective analysis using the OptumLabs® Data Warehouse using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes of distal radius fracture. Of the 34,184 distal radius fractures analysed, 11,731 (34%) underwent operative management. Short-term complications within 90 days of fracture identified an overall complication rate of 16.6 per 1000 fractures and the 1-year upper extremity-specific complication rate was 287 per 1000 fractures. Overall, post-injury stiffness was the most common 1-year upper extremity-specific complication and was associated with operative management (202.8 vs. 123.4 per 1000 fractures, operative vs. non-operative, p < 0.01). Secondary procedures were significantly more common following non-operative management (8.7% vs. 43%, operative vs. non-operative, p < 0.01) with carpal tunnel release representing the most common secondary procedure. Operative management of distal radius fractures resulted in significantly fewer secondary procedures at the expense of increased overall 1-year complication rates, specifically stiffness.
KW - Distal radius fracture
KW - external fixation
KW - non-operative
KW - open reduction and internal fixation
KW - percutaneous pinning
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U2 - 10.1177/1753193420941310
DO - 10.1177/1753193420941310
M3 - Article
C2 - 32752977
AN - SCOPUS:85089144124
SN - 1753-1934
VL - 46
SP - 159
EP - 166
JO - Journal of Hand Surgery: European Volume
JF - Journal of Hand Surgery: European Volume
IS - 2
ER -