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大常见骨折。对于经常独自生活的老年人来说，DRF后手部功能的丧失是相当残疾的。对这一群体的治疗是有争议的。由于老年患者功能需求低，一些外科医生会接受保守治疗不可避免的畸形。其他人会提倡钢板固定手术，让患者尽早使用双手，以恢复独立生活。尽管存在这些持续的争论，但尚未开展一项研究，以了解老年人DRF治疗的国家经验。

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.