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The Declining Use of Wrist-Spanning External Fixators.

Venus Vakhshori1, Alexis D Rounds1, Nathanael Heckmann1

  • 1Department of Orthopaedic Surgery, Keck Medical Center at the University of Southern California, Los Angeles, USA.

Hand (New York, N.Y.)
|August 8, 2018
PubMed
Summary

Wrist external fixation for distal radius fractures significantly declined from 2003 to 2014. This treatment was more common in males, low-income patients, and those treated in rural hospitals.

Keywords:
National Inpatient Sampledistal radius fracturewrist external fixatorwrist fracturewrist-spanning external fixation

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Area of Science:

  • Orthopedic surgery
  • Trauma care
  • Medical device utilization

Background:

  • External fixation is a traditional treatment for complex distal radius fractures.
  • This method has a high complication rate and decreasing use.
  • Trends in external fixation for distal radius fractures are not well-documented.

Purpose of the Study:

  • To describe trends in external fixation utilization for distal radius fractures.
  • To identify patient and hospital factors associated with external fixation use.

Main Methods:

  • Analysis of Nationwide Inpatient Sample data from 2003 to 2014.
  • Identification of patients with distal radius fractures treated with external fixation.
  • Reporting of annual incidence and associated demographic/hospital variables.

Main Results:

  • 51,766 (8.7%) of 593,929 distal radius fractures used external fixation.
  • External fixation use decreased by 73.7% from 2003 (17.4%) to 2014 (4.9%).
  • Males, low-income patients, and those in rural, nonteaching, private hospitals were more likely to receive external fixation.

Conclusions:

  • External fixation for distal radius fractures has shown a consistent decline.
  • Specific patient demographics and hospital types are associated with higher external fixation rates.