Patterns of injury and treatment for distal radius fractures at a major trauma centre

BACKGROUND Fractures of the distal radius are common and form a considerable proportion of the trauma workload. We undertook a study to examine the patterns of injury and treatment for adult patient presenting with distal radius fractures to a major trauma centre serving an urban population. METHODS We undertook a retrospective cohort study to identify all patients treated at our major trauma centre for a fracture of the distal radius between June 2018 and May 2021. We reviewed the medical records and imaging for each patient to examine patterns of injury and treatment. We undertook a binomial logistic regression to produce a predictive model for operative fixation or inpatient admission. RESULTS Five hundred and seventy-one fractures of the distal radius were treated at our centre during the study period. 146 (26%) patients required an inpatient admission and 385 surgical procedures for fractures of the distal radius were recorded between June 2018 and May 2021. The most common mechanism of injury was a fall from a height of one metre or less. Fifty-nine percent of fractures were treated non-operatively and of those patients treated with surgery, locked anterior-plate fixation was the preferred technique (79%). CONCLUSION The epidemiology of distal radius fractures treated at our major trauma centre replicated the classical bimodal distribution described in the literature. Patient age, open fractures and fracture classification were factors correlated with the decision to treat the fracture operatively. While most fractures were treated non-operatively, locked anterior-plate fixation remains the predominant method of fixation for fractures of the distal radius. This is despite questions and continued debate about the best method of surgical fixation for these injuries. The epidemiology of distal radius fractures treated at our major trauma centre reflects that reported in the literature. Even in a major trauma setting, most distal radius fractures can be treated non-operatively and where surgical fixation is required, locked anterior plate fixation is the preferred method of treatment. 32% of patients aged 65 years or older who sustained a distal radius fracture required inpatient admission, often for social or non-clinical reasons