Outcomes and complications of operative versus non-operative management of distal radius fractures in adults under 65 years of age

Brent R. DeGeorge, Holly K. Van Houten, Raphael Mwangi, Lindsey R Sangaralingham, Sanjeev Kakar

Research output: Contribution to journalArticle

Abstract

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. Level of evidence: III.

Original languageEnglish (US)
JournalJournal of Hand Surgery: European Volume
DOIs
StateAccepted/In press - 2020

Keywords

  • Distal radius fracture
  • external fixation
  • non-operative
  • open reduction and internal fixation
  • percutaneous pinning

ASJC Scopus subject areas

  • Surgery

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