Outcomes and complications of operative versus non-operative management of distal radius fractures in adults under 65 years of age. (February 2021)

• Record Type: Journal Article
• Authors: DeGeorge, Brent R.; Van Houten, Holly K.; Mwangi, Raphael; R Sangaralingham, Lindsey; Kakar, Sanjeev
• Is Part Of: Journal of hand surgery. Volume 46:Number 2(2021)
• Page Start: 159
• Page End: 166
• Publication Date: 2021-02
• Subjects: Distal radius fracture -- open reduction and internal fixation -- percutaneous pinning -- non-operative -- external fixation; 617.575059
• DOI: 10.1177/1753193420941310
• Languages: English
• ISSNs: 1753-1934

Abstract

To compare the outcomes of non-operative versus operative treatment for distal radius fractures in patients aged from 18 to 64 years, we performed a retrospective analysis using the OptumLabs® Data Warehouse using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes of distal radius fracture. Of the 34, 184 distal radius fractures analysed, 11, 731 (34%) underwent operative management. Short-term complications within 90 days of fracture identified an overall complication rate of 16.6 per 1000 fractures and the 1-year upper extremity-specific complication rate was 287 per 1000 fractures. Overall, post-injury stiffness was the most common 1-year upper extremity-specific complication and was associated with operative management (202.8 vs. 123.4 per 1000 fractures, operative vs. non-operative, p < 0.01). Secondary procedures were significantly more common following non-operative management (8.7% vs. 43%, operative vs. non-operative, p < 0.01) with carpal tunnel release representing the most common secondary procedure. Operative management of distal radius fractures resulted in significantly fewer secondary procedures at the expense of increased overall 1-year complication rates, specifically stiffness. Level of evidence: III