Epidemiology and treatment of distal radius fractures: current concept based on fracture severity and not on age

Sander, Anna; Leiblein, Maximilian; Sommer, Katharina; Marzi, Ingo; Schneidmüller, Dorien; Frank, Johannes

doi:10.1007/s00068-018-1023-7

Cited by 36 publications

(33 citation statements)

References 26 publications

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“…The proportion of type-C fracture increased from 16% in 2001 to 39% in 2016. A similar observation has recently been made in Germany, where the proportion of type-A fractures was lower and of type-C fractures was higher than previously reported in the literature [27]. The higher incidence of type-C fracture and the lower incidence of type-A fracture compared with 2001 was seen in all age groups, not only in the elderly.…”

Section: Discussionsupporting

confidence: 88%

Incidence of distal radius fracture in a general population in southern Sweden in 2016 compared with 2001

et al. 2020

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In this population-based study, we compared the incidence of distal radius fracture in 2016 with that in the same region's adult general population in 2001 using radiographs to identify fracture cases. We showed that the incidence decreased by 24% in 2016 compared with 2001 indicating an important development.Introduction We conducted an epidemiological study on residents of northeastern Skåne in southern Sweden (population 182,000) to determine the overall incidence of distal radius fracture and the incidence according to age, sex, and fracture characteristics in the region's adult population during 2016, and to study the change in incidence in the same general population between 2001 and 2016 using wrist radiographs to identify fracture cases. Methods Two orthopedic surgeons examined all wrist radiographs performed at the only two emergency hospitals in the study region to identify individuals, above 18 years of age, who sustained fracture of the distal radius during 2016. We used Poisson regression analysis adjusting for age, sex, and at-risk population to compare the incidence in 2016 with the incidence in 2001, previously estimated using similar methodology. Results The overall incidence in 2016 was 22 (95% CI 20-25) per 10,000; the incidence in women was 34 (95% CI 30-39) and in men was 10 (95% CI 8-12) per 10,000. The overall incidence in 2016 was 0.76 (95% CI 0.70-0.82) of the incidence in 2001 (p < 0.0001). The incidence in the 3 age groups 19-49, 50-79, and ≥ 80 years was 0.91 (95% CI, 0.69-1.20), 0.67 (95% CI, 0.55-0.82), and 0.49 (95% CI, 0.25-0.97) of the incidence in 2001, respectively. Conclusion In a general population in Sweden, a statistically significant and clinically important decrease in the incidence of distal radius fracture occurred between 2001 and 2016, driven by lower incidence in individuals 50 years or older.

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Section: Discussionsupporting

confidence: 88%

Incidence of distal radius fracture in a general population in southern Sweden in 2016 compared with 2001

et al. 2020

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“…Similarly, we found that the severity of the fracture (Fernandez classification, P = 0.041 and AO classification, P = 0.037) and the presence of an associated distal radioulnar joint instability or wrist joint dislocation ( P = 0.015) influenced the decision to operate. Current epidemiological data also confirmed that the indication for surgical treatment was closely correlated with fracture severity . Distal radius fracture associated with distal radioulnar joint instability or radiocarpal joint dislocation was more complicated and tended to be operated on.…”

Section: Discussionmentioning

confidence: 70%

Factors associated with the decision for operative versus conservative treatment of displaced distal radius fractures in the elderly

Yang

Xie

et al. 2019

ANZ Journal of Surgery

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Background: The treatment of senile distal radius fractures had not been clearly defined. The objective of this study was to identify the factors associated with the decision for operative treatment of displaced distal radius fractures in patients aged over 55 years. Methods: Data of 318 patients with displaced distal radius fractures were collected on patient-, fracture-and surgeon-related characteristics that were plausibly related to the decision for operation. Mean comparisons or chi-squared test were used for univariate analysis of the above-mentioned factors, and then multiple logistic regression was used to identify factors associated with the decision for operation. Results: Univariate analysis showed that age, osteoporosis, Charlson score, associated orthopaedic injuries requiring surgery, Orthopaedic Trauma Association (AO) and Fernandez classification, radial height, volar tilt, volar/dorsal comminution, ulnar variance, intra-articular displacement/step-off, associated distal radioulnar joint instability or radiocarpal joint dislocation and subspecialty of treating surgeons had statistically significant association with operative intervention. In the multivariate analysis, the predictors of operative intervention were younger patient age (P = 0.028), associated orthopaedic injuries requiring surgery (P = 0.020), higher AO classification (P = 0.037), higher Fernandez classification (P = 0.041), radial shortening >5 mm (P = 0.020), volar tilt > −10 (P = 0.020), volar/dorsal comminution (P = 0.020), ulnar variance >5 mm (P = 0.023), intra-articular displacement/step-off >2 mm (P = 0.004), associated distal radioulnar joint instability or radiocarpal joint dislocation (P = 0.047) and treatment by an upper extremity specialist (P = 0.038). Conclusion: The decision for surgery was predominantly influenced by the characteristics and severity of the fracture. Patients' age and treatment by an upper extremity specialist were also significant factors associated with a higher likelihood of operative intervention. © 2019 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E428-E432 ANZJSurg.com © 2019 Royal Australasian College of Surgeons E432Wu et al.

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“…Fractures of the ulnar head with an intraarticular step or instability are treated with Kirschner wires or locking plates [2]. To achieve postoperative free range of motion without restrictions, therapy of every fracture consists in restoration of the anatomical articular surface, adjustment and fixation of differences in length, axis and rotation of both bones of the forearm [5]. These days, fractures of the distal forearm are rarely treated conservatively [5].…”

Section: Discussionmentioning

confidence: 99%

If there is smoke, there must be fire – Isolated distal, non-displaced, intraarticular ulna fracture: A case report

Manz

Jensen

Allemann

et al. 2019

International Journal of Surgery Case Reports

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Epidemiology and treatment of distal radius fractures: current concept based on fracture severity and not on age

Cited by 36 publications

References 26 publications

Incidence of distal radius fracture in a general population in southern Sweden in 2016 compared with 2001

Incidence of distal radius fracture in a general population in southern Sweden in 2016 compared with 2001

Factors associated with the decision for operative versus conservative treatment of displaced distal radius fractures in the elderly

If there is smoke, there must be fire – Isolated distal, non-displaced, intraarticular ulna fracture: A case report

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