Incidence of Corrective Procedures After Nonoperatively Managed Distal Radius Fractures in the Elderly.

Autor:	Satariano NP; Department of Orthopaedic Surgery (Dr. Satariano, Dr. Lalchandani, and Dr. Immerman), School of Medicine, University of California, San Francisco, and the UCSF School of Medicine (Ms. Menchaca), San Francisco, California., Lalchandani GR; Department of Orthopaedic Surgery (Dr. Satariano, Dr. Lalchandani, and Dr. Immerman), School of Medicine, University of California, San Francisco, and the UCSF School of Medicine (Ms. Menchaca), San Francisco, California., Menchaca SE; Department of Orthopaedic Surgery (Dr. Satariano, Dr. Lalchandani, and Dr. Immerman), School of Medicine, University of California, San Francisco, and the UCSF School of Medicine (Ms. Menchaca), San Francisco, California., Immerman I; Department of Orthopaedic Surgery (Dr. Satariano, Dr. Lalchandani, and Dr. Immerman), School of Medicine, University of California, San Francisco, and the UCSF School of Medicine (Ms. Menchaca), San Francisco, California.
Jazyk:	angličtina
Zdroj:	Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews [J Am Acad Orthop Surg Glob Res Rev] 2019 Nov 27; Vol. 3 (11). Date of Electronic Publication: 2019 Nov 27 (Print Publication: 2019).
DOI:	10.5435/JAAOSGlobal-D-19-00159
Abstrakt:	Although the majority distal radius fractures in the elderly are initially managed nonoperatively, the true incidence of subsequent corrective surgery is unknown. The purpose of this study was to determine the incidence and predictors of corrective surgery after conservative management. Methods: ICD-9 and Current Procedural Terminology codes were queried from the Medicare 5% sample to select patients aged 65 years and older undergoing nonsurgical treatment of distal radius fractures with a minimum 5-year follow-up. Rates of subsequent ipsilateral wrist surgery were correlated against patient age, sex, geographic region, and initial closed reduction. Results: Five thousand eighty patients with a mean age of 78.3 years were included. Fifty-five patients (1.1%) had undergone subsequent wrist surgery at a median time of 182 days after injury. The youngest cohort (65 to 69 years) had a significantly higher operation rate (1.9%, P = 0.007) than the oldest cohort (80+ years) (0.5%, P = 0.004). There was no notable difference in corrective procedures between sex, geographic region, and initial closed reduction. Discussion: Once surgical intervention is deemed unnecessary per standard guidelines, the data support successful nonsurgical management in a large majority of patients but highlight a small subset of younger patients who remain at increased risk of requiring additional surgery. (Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)
Databáze:	MEDLINE
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