Mahmoud Yusuf, Chung Juliet, Pirzada Wali, Ilyas Asif M
Department of Orthopedics, Hackensack Meridian School of Medicine, NJ.
Department of Orthopedics, Penn State College of Medicine, Hershey, PA.
J Hand Surg Glob Online. 2024 Feb 19;6(4):477-483. doi: 10.1016/j.jhsg.2024.01.005. eCollection 2024 Jul.
Distal radius fractures (DRF) are among the most commonly encountered fractures. The population of the United States is rapidly growing, aging, and diversifying. This study was undertaken to better understand current incidences and treatment trends across all ages, gender, and races to inform resource allocation and to potentially address treatment inequities.
The TriNetX US Collaborative Network was queried for all patients diagnosed with DRFs from 2017 to 2022. Cohorts were defined by inclusion and exclusion of Current Procedural Terminology procedure codes and categorized into operative and nonsurgical groups. Statistical analysis was performed to determine differences in management among demographic groups across the 6-year time period.
Incidence rates of operative intervention for DRF increased from 19.6% in 2017 to 23.6% in 2022. Incidence rates of operative intervention increased from 21.7% to 25.2% for females and from 15.3% to 19.7% for males. A bimodal distribution was observed in females with more fractures occurring in the pediatric and geriatric ages, but this distribution was not observed in males. All demographic groups had an overall higher incidence of nonsurgical intervention. Patients aged 40-64 years were more likely to undergo operative intervention than patients 18-39 years. Females were more likely to undergo operative intervention than males. White patients were more likely to undergo operative intervention than Black patients and Asian patients.
The incidence of DRFs continues to climb, as does their rate of operative management. The classic bimodal distribution was observed in females, but not males. However, differences in management of DRFs were also observed across different demographic groups with ongoing racial disparities. Future consideration should be taken into optimizing treatment disparities relative to demographic status.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognosis IV.
桡骨远端骨折(DRF)是最常见的骨折类型之一。美国人口正在迅速增长、老龄化且日益多样化。本研究旨在更好地了解各年龄、性别和种族的当前发病率及治疗趋势,以为资源分配提供信息,并可能解决治疗不平等问题。
查询TriNetX美国协作网络中2017年至2022年所有诊断为DRF的患者。通过纳入和排除当前手术操作术语程序代码来定义队列,并分为手术组和非手术组。进行统计分析以确定6年期间不同人口统计学组之间管理的差异。
DRF手术干预的发生率从2017年的19.6%上升至2022年的23.6%。女性手术干预的发生率从21.7%升至25.2%,男性从15.3%升至19.7%。女性中观察到双峰分布,在儿童和老年时期骨折更多,但男性中未观察到这种分布。所有人口统计学组非手术干预的总体发生率更高。40 - 64岁的患者比18 - 39岁的患者更有可能接受手术干预。女性比男性更有可能接受手术干预。白人患者比黑人患者和亚洲患者更有可能接受手术干预。
DRF的发病率及其手术治疗率持续攀升。女性中观察到经典的双峰分布,但男性中未观察到。然而,不同人口统计学组在DRF管理方面也存在差异,种族差异持续存在。未来应考虑优化与人口统计学状况相关的治疗差异。
研究类型/证据水平:预后IV级。