AAHS Main Site  | Past & Future Meetings  
American Association for Hand Surgery
Meeting Home
Sunglasses
Concert
Poolside
Turtle

Back to 2017 Annual Meeting Program


Patient Demographics and Complications Following Operative Treatment Distal Radius Fractures: A Review of 260,953 Cases
Kent T. Yamaguchi, MD; Robert C. Maciel, MS; Andrew R. Jensen, MD; Zorica Buser, PhD; Jason Ghodasra, MD; Jeffrey Wang, MD; Frank A. Petrigliano, MD; Casimir Dowd, MD
UCLA, Los Angeles, CA

Introduction: Distal radius fractures (DRFs) are becoming more prevalent as the population ages, with an estimated prevalence of 6% in women by age 80. The purpose of this study was to investigate the relationship between comorbidities and complication rates after operative fixation of DRFs in the Medicare population.

Materials & Methods: We identified all Medicare patients treated for DRFs between 2005-2012 by cross-referencing the corresponding CPT and ICD-9 codes. ORIF patients were stratified by diagnoses of osteoporosis, type 2 diabetes (T2DM), tobacco-use, obesity, and male gender. Outcomes evaluated were 90d rates of surgical-site infections (SSIs), osteomyelitis, wound complications (WC), nerve injury (NI), compartment syndrome, medical complications, 1-year rates of malunion, distal radio-ulnar joint instability (DRUJ) instability, and complex regional pain syndrome (CRPS). Odds ratios and confidence intervals were determined and chi-squared tests for association conducted between each risk factor and outcome of interest with statistical significance set at p<0.05.

Results: 260,953 patients were treated for DRFs with an incidence of 5.97 per 10,000 Medicare patients. 43.3% of this population underwent ORIF, of which 22.6% had osteoporosis, 20.2% T2DM, 11.38% used tobacco, 7.05% were obese, and 15.4% were male. A diagnosis of osteoporosis was associated with significantly increased odds of SSIs, WC, malunion, and medical complications. T2DM was associated with significantly increased odds of SSIs, osteomyelitis, WC, NI, diagnosis of malunion, and medical complications. Tobacco use disorder was significantly associated with increased odds of SSIs, osteomyelitis, WC, NI, CRPS, diagnosis and treatment of malunion, DRUJ dislocation, treatment for DRUJ instability, and medical complications. Obesity was associated with significantly increased odds of SSIs, osteomyelitis, WC, NI, diagnosis and treatment of malunion, treatment for DRUJ instability, and medical complications. Male gender was associated with significantly increased odds of SSIs, osteomyelitis, WC, NI, diagnosis and treatment of malunion, DRUJ dislocation, DRUJ instability.

Conclusions: To our knowledge, this is the largest study evaluating demographics and complication rates in Medicare patients undergoing ORIF for DRFs. Each patient variable was associated with increased risk of SSI. T2DM, obesity, smoking, and male gender each relate with increased risk of infection, nerve injury, wound complications, and malunion. In conclusion, patient demographics should be closely examined when determining treatment for distal radius fractures in order to optimize patient outcomes.


Back to 2017 Annual Meeting Program