Motisi Matthew, Kurowicki Jennifer, Berglund Derek D, Triplet Jacob J, Disla Shanell, Niedzielak Timothy, Levy Jonathan C
Broward Health Medical Center, 1800 NW 49th Street Fort Lauderdale, FL 33309, USA.
Holy Cross Orthopedic Institute, 5597 N. Dixie Highway Fort Lauderdale, FL 33334, USA.
Open Orthop J. 2017 Mar 31;11:239-247. doi: 10.2174/1874325001711010239. eCollection 2017.
Advancement in surgical techniques and implants has improved the ability to manage radial head and olecranon fractures. However, trends in management of these fractures are largely unstudied.
This purpose of this study is to evaluate management trends for these common fractures.
A retrospective review of a comprehensive Humana database was performed using Pearl Diver supercomputer (Warsaw, IN, USA) for radial head and neck (RHNF) and olecranon fractures (OF) between 2007 and 2014. Treatment methods including open reduction internal fixation (ORIF), radial head arthroplasty (RHA), and non-operative treatment were reviewed. Total reported incidence of office visits and utilization of each treatment modality were investigated. Sub-analysis with stratification by age 15-74 and greater than 75-years was performed for OF.
A total of 10,609 OF and 20,400 RHNF were identified between 2007 and 2014. A significant trend increase in the annual incidence of RHNF (266 cases/year, p<0.001) and OF (133.9 cases/year, p=0.001) was observed. A significant trend in annual percent utilization of RHA (0.22% per year, p=0.011) and a significant trend in the annual percent utilization of ORIF (-1.0% per year, p=0.004) and non-operative management (-0.53% per year, p=0.046) was observed for RHNF. A significant trend was observed in percent utilization (0.40% per year, p=0.022) for OF non-operative management, especially in patients over 75 years (66% per year, p=0.034).
The percentage of patients being treated with RHA is increasing. Non-operative management of OF has increased, specifically in the patients who are over 75 years.
外科技术和植入物的进步提高了处理桡骨头和尺骨鹰嘴骨折的能力。然而，这些骨折的治疗趋势在很大程度上尚未得到研究。
本研究的目的是评估这些常见骨折的治疗趋势。
使用Pearl Diver超级计算机（美国印第安纳州华沙）对Humana综合数据库进行回顾性分析，研究2007年至2014年间桡骨头和颈部（RHNF）及尺骨鹰嘴骨折（OF）的情况。回顾了包括切开复位内固定（ORIF）、桡骨头置换术（RHA）和非手术治疗在内的治疗方法。调查了报告的门诊就诊总数和每种治疗方式的使用情况。对尺骨鹰嘴骨折患者按年龄15 - 74岁和大于75岁进行分层亚分析。
2007年至2014年间共识别出10609例尺骨鹰嘴骨折和20400例桡骨头和颈部骨折。观察到桡骨头和颈部骨折的年发病率有显著上升趋势（每年266例，p < 0.001），尺骨鹰嘴骨折的年发病率也有显著上升趋势（每年133.9例，p = 0.001）。对于桡骨头和颈部骨折，观察到桡骨头置换术的年使用百分比有显著上升趋势（每年0.22%，p = 0.011），切开复位内固定的年使用百分比有显著下降趋势（每年 - 1.0%，p = 0.004），非手术治疗的年使用百分比也有显著下降趋势（每年 - 0.53%，p = 0.046）。对于尺骨鹰嘴骨折，观察到非手术治疗的使用百分比有显著上升趋势（每年0.40%，p = 0.022），特别是在75岁以上的患者中（每年66%，p = 0.034）。
接受桡骨头置换术治疗的患者比例正在增加。尺骨鹰嘴骨折的非手术治疗有所增加，特别是在75岁以上的患者中。
