Abstract
Background The purpose of this study is to assess the epidemiology, population-specific treatment
trends, and complications of distal radius fractures in the United States.
Methods The PearlDiver database (Humana [2007–2014], Medicare [2005–2014]) was used to access
US inpatient and outpatient data for all patients who had undergone operative and
nonoperative treatment for a distal radius fracture in the United States. Epidemiologic
analysis was performed followed by age-based stratification, to assess prevalence,
treatment trends, and rates of complications.
Results A total of 1,124,060 distal radius treatment claims were captured. The incidence
of distal radius fractures follows a bimodal distribution with distinct peaks in the
pediatric and elderly population. Fractures in the pediatric population occurred predominately
in males, whereas fractures in the elderly population occurred more frequently in
females. The most commonly used modality of treatment was nonoperative; however, the
use of internal fixation increased significantly during the study period, from 8.75
to 20.02%, with a corresponding decrease in percutaneous fixation. The overall complication
rate was 8.3%, with mechanical symptoms most frequently reported.
Conclusions The last decade has seen a significant increase in the use of internal fixation as
treatment modality for distal radius fractures. The impetus for this change is likely
multifactorial and partly related to recent innovations including volar locking plates
and an increasingly active elderly population. The implicated financial cost must
be weighed against the productivity cost of maintaining independent living to determine
the true burden to the healthcare system.
Keywords
distal radius - epidemiology - PearlDiver - pediatric - elderly - age stratification
