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Surgical Treatment Is Increasing for Distal Radius Fractures Results from a Nationwide Registry Study
Cecilia Mellstrand Navarro, MD; Hans Pettersson, PhD; Hans Tornkvist, Professsor; Sari Ponzer, Professor
Karolinska Institute, Stockholm, Sweden

Introduction: Distal radius fractures are the most common fractures in all age groups. The malalignment and deformity seen after nonsurgical treatment is sometimes not acceptable and surgery is recommended when there is a large displacement or a large intraarticular gap or step. The method of choice for surgical treatment has recently changed and the volar plate is now the predominant surgical method in Scandinavia. The aim with this study was to investigate the epidemiology of distal radius fractures in the Swedish population and to present what treatment methods that were used for distal radius fractures during the years 2005-2010.
Materials and Methods: Population based data was retrieved from the Swedish National Board of Health and Welfare Registry. The study population for the present study consists of all patients diagnosed with a fracture to the wrist (S52.50, S52.51, S52.60, S52.61) during the period 1 January 2005 until 31 December 2010. Data was analyzed regarding occurrence of fractures and the choice of treatment.
Results: There were a total of 177 893 distal radius fractures in Sweden during the years 2005 2010. The incidence rate was 32/10 000 person years. Mean age was 44 years (0-104) and somewhat higher for surgically treated patients. There was a female dominance of 60:40. The proportion of non-surgically treated fractures diminished from 84% (n=24 646) in 2005 to 80% (n=24 215) in 2010. The mean age for surgically and non-surgically treated patients did not change. Plate fixation increased by 370% (from 1 014 in 2005 to 3 750 in 2010) and external fixation diminished by 65% (1 957 in 2005 to 677 in 2010). The change was most marked in the age group 51-75 years where plate fixation increased by 383 % (518 in 2005 to 2 316 in 2010). Among patients over the age of 75 surgical treatment diminished by 4% (n= 724) even if plate fixation increased by 270% (166 in 2005 to 522 in 2010).
Conclusions: In Sweden, there is an increasing tendency to treat distal radius fractures with a surgical procedure. The previously reported increase of the use of plating is confirmed with a threefold increase over a 6 year period. Fracture incidence and distribution of sex and age remain unchanged during the investigation period. If this development continues, costs for distal radius fracture care will increase dramatically.


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