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Trends in Management of Radial Head Fractures: A 21 Year Review.
Evan Herbert Richman, MD; Dylan R Rakowski, MD; Louis W. Catalano, MD
University of Colorado, Aurora, CO
Abstract: Purpose: The optimal treatment of radial head fractures is still being defined. This study aimed to analyze the epidemiological patterns and trends in physician reimbursement for all radial head fractures billed to Medicare since the year 2000.
MethodsThe study utilized the Medicare Part B National Summary Files to extract data for all Current Procedural Terminology (CPT) codes pertinent to radial head fractures. Data collected included true physician reimbursement, utilization rates, and patient charges annually from 2000 to 2021. To ensure comparability, all financial figures were adjusted for inflation to reflect the values in the latest year on record, 2021.
ResultsFrom 2000-2021 a total of 203,458 radial head fractures were billed to Medicare. Nonoperative management decreased by 3%, the rates of ORIF decreased by 28%, and the rates of RHA increased by 457%. After adjusting all data for inflation to 2021 dollars, average physician reimbursement increased by 22% averaged across all radial head procedures. As of 2021, RHA resulted in a 101.3% higher physician compensation than ORIF.
ConclusionThis study contributes significantly to the ongoing discourse on current treatment strategies for radial head fractures. Most radial head fractures within the elderly population are managed nonoperatively. When these injuries do necessitate operative intervention, RHA is more commonly utilized compared to ORIF. Further, physicians are receiving higher financial compensation to perform RHA. Lastly, physician reimbursement for radial head operations are not facing similar reimbursement decreases compared to other orthopedic procedures.
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