Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-12-2018 | Original Article • WRIST - FRACTURES

Complication rates by surgeon type after open treatment of distal radius fractures

Authors: Jeremy Truntzer, Kevin Mertz, Sara Eppler, Kevin Li, Michael Gardner, Robin Kamal

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 8/2018

Abstract

Background

In distal radius fracture repair, complications often lead to reoperation and increased cost. We examined the trends and complications in open reduction internal fixation of distal radius fractures across hand specialist and non-hand specialist surgeons.

Methods

We examined claims data from the Humana administrative claims database between 2007 and 2016. International Classification of Disease, 9th Edition and Current Procedural Terminology codes were searched related to distal radius fractures repaired by open reduction internal fixation. Patients were filtered based on initial treatment by a hand specialty or non-hand specialty surgeon. Complications were reported within 1 year of surgical treatment in the following distinct categories: non-union, malunion, extensor/flexor tendon repair, CRPS, infection. Descriptive statistics were reported.

Results

Hand specialists accounted for 182 procedures compared with 7708 procedures by non-hand specialty orthopaedic or general surgeons. There was an increase in the total number of procedures performed by hand specialists across the years of study, with a higher percentage of intra-articular cases completed by hand specialists (80.7%) compared to non-hand specialists (70.1%). Overall, the complication rates of hand specialists (6.5%) were higher than that of non-specialists (4.7%).

Conclusions

The results of this study demonstrate a small difference in overall complications for open reduction internal fixation of distal radius fractures by hand specialists in comparison to non-specialists despite treating a higher percentage of intra-articular fractures. Future work controlling for factors unaccounted for in claims-based analyses, such as fracture complexity, patient comorbidities, and surgeon factors are needed.

Type of study/level of evidence

Therapeutic IV.

Vlček M, Pech J, Musil V, Stingl J (2015) Conservative and surgical treatment for distal ulna fractures associated with distal radius fractures. Acta Chir Orthop Traumatol Cech 82:412–417PubMed

Walenkamp MMJ, Goslings JC, Beumer A et al (2014) Surgery versus conservative treatment in patients with type A distal radius fractures, a randomized controlled trial. BMC Musculoskelet Disord 15:90. https://doi.org/10.1186/1471-2474-15-90 CrossRefPubMedPubMedCentral

White JS (2013) Fractures of the distal radius. Adv Emerg Nurs J 35:8–15. https://doi.org/10.1097/TME.0b013e31827ef6e2 CrossRefPubMed

Liverneaux PA (2018) New trends in distal radius fractures. Eur J Orthop Surg Traumatol Orthop Traumatol. https://doi.org/10.1007/s00590-018-2222-y CrossRef

Loisel F, Bourgeois M, Rondot T et al (2018) Treatment goals for distal radius fractures in 2018: recommendations and practical advice. Eur J Orthop Surg Traumatol Orthop Traumatol. https://doi.org/10.1007/s00590-018-2196-9 CrossRef

Shauver MJ, Yin H, Banerjee M, Chung KC (2011) Current and future national costs to medicare for the treatment of distal radius fracture in the elderly. J Hand Surg 36:1282–1287. https://doi.org/10.1016/j.jhsa.2011.05.017 CrossRef

Costa ML, Achten J, Plant C et al (2015) UK DRAFFT: a randomised controlled trial of percutaneous fixation with Kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius. Health Technol Assess Winch Engl 19:1–124, v–vi. https://doi.org/10.3310/hta19170 CrossRef

Chung KC, Shauver MJ, Birkmeyer JD (2009) Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am 91:1868–1873. https://doi.org/10.2106/JBJS.H.01297 CrossRefPubMedPubMedCentral

Jiang JJ, Phillips CS, Levitz SP, Benson LS (2014) Risk factors for complications following open reduction internal fixation of distal radius fractures. J Hand Surg 39:2365–2372. https://doi.org/10.1016/j.jhsa.2014.09.016 CrossRef

10.

Obert L, Loisel F, Huard S et al (2015) Plate fixation of distal radius fracture and related complications. Eur J Orthop Surg Traumatol Orthop Traumatol 25:457–464. https://doi.org/10.1007/s00590-014-1550-9 CrossRef

11.

Schick CW, Koehler DM, Martin CT et al (2014) Risk factors for 30-day postoperative complications and mortality following open reduction internal fixation of distal radius fractures. J Hand Surg 39(2373–2380):e1. https://doi.org/10.1016/j.jhsa.2014.09.017 CrossRef

12.

Meeuwis MA, de Jongh MAC, Roukema JA et al (2016) Technical errors and complications in orthopaedic trauma surgery. Arch Orthop Trauma Surg 136:185–193. https://doi.org/10.1007/s00402-015-2377-5 CrossRefPubMed

13.

Salzler MJ, Lin A, Miller CD et al (2014) Complications after arthroscopic knee surgery. Am J Sports Med 42:292–296. https://doi.org/10.1177/0363546513510677 CrossRefPubMed

14.

Smetana BS, Zhou X, Hurwitz S et al (2016) Effects of hand fellowship training on rates of endoscopic and open carpal tunnel release. J Hand Surg 41:e53–e58. https://doi.org/10.1016/j.jhsa.2015.12.027 CrossRef

15.

Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC (2011) A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg 36(824–835):e2. https://doi.org/10.1016/j.jhsa.2011.02.005 CrossRef

16.

Lutz K, Yeoh KM, MacDermid JC et al (2014) Complications associated with operative versus nonsurgical treatment of distal radius fractures in patients aged 65 years and older. J Hand Surg 39:1280–1286. https://doi.org/10.1016/j.jhsa.2014.04.018 CrossRef

17.

Mathews AL, Chung KC (2015) Management of complications of distal radius fractures. Hand Clin 31:205–215. https://doi.org/10.1016/j.hcl.2014.12.002 CrossRefPubMedPubMedCentral

18.

Minhas SV, Chow I, Patel AA, Kim JYS (2014) Surgeon specialty differences in single-level anterior cervical discectomy and fusion. Spine 39:1648. https://doi.org/10.1097/BRS.0000000000000499 CrossRefPubMed

19.

Kim BD, Edelstein AI, Hsu WK et al (2014) Spine surgeon specialty is not a risk factor for 30-day complication rates in single-level lumbar fusion: a propensity score-matched study of 2528 patients. Spine 39:E919–E927. https://doi.org/10.1097/BRS.0000000000000394 CrossRefPubMed

20.

Sathiyakumar V, Thakore RV, Greenberg SE et al (2015) Adverse events in orthopaedics: Is trauma more risky? An analysis of the NSQIP data. J Orthop Trauma 29:337–341. https://doi.org/10.1097/BOT.0000000000000293 CrossRefPubMed

21.

Hageman MGJS, Bossen JKJ, Smith RM, Ring D (2014) Predictors of readmission in orthopaedic trauma surgery. J Orthop Trauma 28:e247–e249. https://doi.org/10.1097/BOT.0000000000000094 CrossRefPubMed

22.

Pugely AJ, Martin CT, Harwood J et al (2015) Database and registry research in orthopaedic surgery: part I: claims-based data. J Bone Joint Surg Am 97:1278–1287. https://doi.org/10.2106/JBJS.N.01260 CrossRefPubMed

Title: Complication rates by surgeon type after open treatment of distal radius fractures
Authors: Jeremy Truntzer
Kevin Mertz
Sara Eppler
Kevin Li
Michael Gardner
Robin Kamal
Publication date: 01-12-2018
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 8/2018
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-018-2236-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Complication rates by surgeon type after open treatment of distal radius fractures

Abstract

Background

Methods

Results

Conclusions

Type of study/level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Type of study/level of evidence

Please log in to get access to this content

Other articles of this Issue 8/2018

Doris Brotz, Michael Weller: Physical therapy for intervertebral disk disease: a practical guide to diagnosis and treatment

Results of the treatment of first carpometacarpal joint osteoarthritis: trapeziectomy alone versus trapeziectomy associated with suspensionplasty

History of surgical treatments for hallux valgus

Pycnodysostosis: the disease of Henri de Toulouse-Lautrec

Functional outcomes of the failed plate fixation in distal tibial fractures salvaged by hexapod external fixator

Wrist hemiarthroplasty for irreparable DRF in the elderly