Understanding Treatment Variation of Distal Radius Fracture in the US Elderly

描述（由申请人提供）：桡骨远端骨折（DRF）是老年人中仅次于髋部骨折的第二常见骨折。DRF后手部功能丧失对于经常独居的老年人来说是相当残疾的。对这一群体的治疗是有争议的。由于老年患者对功能要求低，一些外科医生会接受保守治疗不可避免的畸形。另一些人则主张钢板固定手术，以便尽早使用手，使患者恢复独立生活。尽管这些正在进行的辩论，一项研究，以了解在老年人DRF治疗的国家经验尚未进行。 该项目的具体目的是分析1995年至2006年过去十年的医疗保险数据库，以（1）检查美国老年人DRF的当前治疗以及治疗如何随时间变化，（2）确定老年人DRF治疗的决定因素，以及（3）从并发症和费用方面探索DRF治疗结局。公共卫生相关性：该项目将是第一个全面的人口研究桡骨远端（手腕）骨折治疗在这个国家通过深入检查医疗保险索赔在过去十年的过程中。了解国家在治疗患有这种普遍和昂贵的损伤的老年人方面的经验，将推动该领域的研究人员进行临床试验，以指导未来的治疗。本研究提案的潜在影响是强调和了解DRF的治疗变化，以努力以可接受的成本为不断增长的老年人群提高护理质量。

DESCRIPTION (provided by applicant): Distal radius fracture (DRF) is the second most common fracture in the elderly after hip fracture. Loss of functional use of the hand after DRF is quite disabling for the elderly who often live alone. The treatment of this injury for this group is controversial. Some surgeons will accept the inevitable deformity from conservative treatments because of the elderly patients' low functional demand. Others will advocate plate fixation procedures to allow use of the hands as early as possible in order to return patients to independent living. Despite these ongoing debates, a study to understand the national experience of DRF treatment in the elderly has not been performed. The specific aims of this project are to analyze the Medicare database over the past decade from 1995 to 2006 to (1) examine the current treatment of DRF in the US elderly and how treatment has changed over time, (2) identify determinants of DRF treatment in the elderly, and (3) explore DRF treatment outcomes in terms of complications and costs. PUBLIC HEALTH RELEVANCE: This project will be the first comprehensive population study of distal radius (wrist) fracture treatment in this country through an in-depth examination of Medicare claims over the course of the past decade. Understanding the national experience in treating the elderly suffering from this prevalent and costly injury will propel researchers in this field to conduct clinical trials in guiding future treatments. The potential impact of this study proposal is to highlight and understand treatment variations of DRFs in an effort to improve quality of care at an acceptable cost for the growing elderly population.