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Adkinson JM, Soltys AM, Miller NF, et al. Determinants of distal radius fracture management in polytrauma patients. Hand (N Y). 2013;8(4):382-6doi: 10.1007/s11552-013-9536-3.
Adkinson, J. M., Soltys, A. M., Miller, N. F., Eid, S. M., & Murphy, R. X. (2013). Determinants of distal radius fracture management in polytrauma patients. Hand (New York, N.Y.), 8(4), 382-6. https://doi.org/10.1007/s11552-013-9536-3
Adkinson, Joshua M, et al. "Determinants of distal radius fracture management in polytrauma patients." Hand (New York, N.Y.) vol. 8,4 (2013): 382-6. doi: https://doi.org/10.1007/s11552-013-9536-3
Adkinson JM, Soltys AM, Miller NF, Eid SM, Murphy RX. Determinants of distal radius fracture management in polytrauma patients. Hand (N Y). 2013 Dec;8(4):382-6. doi: 10.1007/s11552-013-9536-3. PMID: 24426953; PMCID: PMC3840753.
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Hand (N Y). 2013 Dec;8(4):382-6. doi: 10.1007/s11552-013-9536-3.

Determinants of distal radius fracture management in polytrauma patients.

Hand (New York, N.Y.)

Joshua M Adkinson, Anna M Soltys, Nathan F Miller, Sherrine M Eid, Robert X Murphy

Affiliations

  1. Department of Surgery, Division of Plastic Surgery, Lehigh Valley Health Network, Cedar Crest & I-78, P.O. Box 689, Allentown, PA 18105-1556 USA.
  2. Drexel University College of Medicine, Philadelphia, PA USA.
  3. Department of Community Health and Health Studies, Lehigh Valley Health Network, Allentown, PA USA.

PMID: 24426953 PMCID: PMC3840753 DOI: 10.1007/s11552-013-9536-3

Abstract

BACKGROUND: Over 640,000 distal radius fractures occur annually in the United States. No studies have been performed looking specifically at polytrauma patients who sustain distal radius fractures. We sought to determine variables affecting management of distal radius fractures in polytrauma patients.

METHODS: An IRB-approved review of trauma patients from 2008-2011 was performed. Records for patients with distal radius fractures were examined, assessing age, gender, Glascow Coma Score, Injury Severity Score, mechanism, type, and characteristics of injury, as well as operative repair. A logistic regression was performed using SPSS 15.0.

RESULTS: The database identified 12,054 patients, 434 sustaining a distal radius fracture. No statistically significant difference in operative repair based on mechanism of injury (p = 0.465) was identified. A total of 285 patients (65.7 %) underwent surgery for distal radius fractures. In univariate analysis, younger age was the only statistically significant demographic predictor of surgical intervention (p = 0.003). In both univariate analysis and logistic regression, open, intra-articular, displaced, and comminuted fractures, as well as those with concomitant ulna fractures were statistically significantly associated with operative repair. Fracture displacement was the most likely variable to be associated with surgical intervention (OR = 12.761, 95 % CI[7.219, 22.556]) (p < 0.001).

CONCLUSIONS: In polytrauma patients, surgery for distal radius fractures is associated with younger age, open, intra-articular, displaced, and comminuted fractures, as well as concomitant ulna fractures. Displaced fractures were almost 13 times more likely to undergo surgical intervention than non-displaced fractures. Gender and mechanism of injury are not predictive of surgical intervention.

Keywords: Distal radius fractures; Polytrauma; Surgery

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