Racial Disparities in Distal Radius Fracture Fixation: A National Database Study

Abstract

Introduction

Racial and ethnic disparities have been noted in multiple orthopedic subspecialties, and recent literature have suggested disparities in distal radius fracture (DRF) treatment based on race/ethnicity in Medicare patients. This study sought to assess for racial and ethnic disparities in DRF care in adult patients of all age groups using a national database.

Materials and Methods

The National Surgical Quality Improvement Program (NSQIP) database was utilized to identify all patients undergoing DRF fixation between 2007 and 2020. Adult patients were identified using current procedural terminology (CPT) codes. The distribution of operative fixation by race/ethnicity was compared with the United States census data from 2016. Complication rates between White and non-White patients were compared using multivariate logistic regression applied to propensity score–matched cohorts.

Results

Among the 21,680 operatively treated DRFs identified, a higher proportion of patients were White compared with non-White patients, when compared with US census data (90% vs. 76.1%, p = 0.03). There was a significant difference in the racial distribution of operatively treated DRFs between non-geriatric and geriatric cohorts (p < 0.005). There were no significant differences observed in rates of complications, readmissions, or reoperations between propensity score–matched cohorts of White and non-White patients (p > 0.05).

Conclusion

Consistent with prior studies on Medicare patients, this database review demonstrates a lower rate of DRF fixation in racial or ethnic minority patients of all adult age groups. This disparity worsened among geriatric patients. These data are relevant for those providing DRF care to help identify and mitigate race and/or ethnicity-based disparities.

Keywords

distal radius fracture - geriatric fracture - racial disparities

Publication History

Received: 23 August 2025

Accepted: 21 October 2025

Article published online:
13 November 2025

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