Understanding Treatment Variation of Distal Radius Fracture in the US Elderly

描述(申请人提供)：桡骨远端骨折(DRF)是老年人中第二常见的骨折，仅次于髋部骨折。对于经常独居的老年人来说，DRF后失去手的功能功能是相当困难的。对于这一群体的这种损伤的治疗是有争议的。由于老年患者的功能需求较低，一些外科医生会接受保守治疗不可避免的畸形。其他人将倡导钢板固定术，以允许尽早使用手，以便让患者恢复独立生活。尽管这些辩论仍在继续，但尚未开展一项研究，以了解各国在老年人DRF治疗方面的经验。 该项目的具体目标是分析从1995年到2006年的过去十年的医疗保险数据库，以(1)检查美国老年人DRF的当前治疗情况以及治疗随时间的变化，(2)确定老年人DRF治疗的决定因素，以及(3)从并发症和成本的角度探讨DRF治疗结果。公共卫生相关性：该项目将通过对过去十年来医疗保险索赔的深入审查，在该国首次对桡骨(手腕)远端骨折治疗进行全面的人口研究。了解国家在治疗患有这种普遍且代价高昂的伤害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。这项研究建议的潜在影响是强调和了解DRF的治疗差异，以努力提高护理质量，并为不断增长的老年人口提供可接受的成本。

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.