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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21AR056988-02
Application #
7656839
Study Section
Health Services Organization and Delivery Study Section (HSOD)
Program Officer
Panagis, James S
Project Start
2008-07-10
Project End
2011-04-30
Budget Start
2009-05-01
Budget End
2011-04-30
Support Year
2
Fiscal Year
2009
Total Cost
$167,200
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Surgery
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Diaz-Garcia, Rafael J; Oda, Takashi; Shauver, Melissa J et al. (2011) A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am 36:824-35.e2
Chung, Kevin C; Shauver, Melissa J; Yin, Huiying (2011) The relationship between ASSH membership and the treatment of distal radius fracture in the United States Medicare population. J Hand Surg Am 36:1288-93
Shauver, Melissa J; Yin, Huiying; Banerjee, Mousumi et al. (2011) Current and future national costs to medicare for the treatment of distal radius fracture in the elderly. J Hand Surg Am 36:1282-7
Shauver, Melissa J; Clapham, Philip J; Chung, Kevin C (2011) An economic analysis of outcomes and complications of treating distal radius fractures in the elderly. J Hand Surg Am 36:1912-8.e1-3
Cavaliere, Christi M; Chung, Kevin C (2010) A cost-utility analysis of nonsurgical management, total wrist arthroplasty, and total wrist arthrodesis in rheumatoid arthritis. J Hand Surg Am 35:379-391.e2
Cavaliere, Christi M; Oppenheimer, Adam J; Chung, Kevin C (2010) Reconstructing the rheumatoid wrist: a utility analysis comparing total wrist fusion and total wrist arthroplasty from the perspectives of rheumatologists and hand surgeons. Hand (N Y) 5:9-18
Squitieri, Lee; Reichert, Heidi; Kim, H Myra et al. (2010) Application of the brief international classification of functioning, disability, and health core set as a conceptual model in distal radius fractures. J Hand Surg Am 35:1795-1805.e1
Chung, Kevin C; Song, Jae W; WRIST Study Group (2010) A guide to organizing a multicenter clinical trial. Plast Reconstr Surg 126:515-23
Chung, Kevin C (2010) Clinical research in hand surgery. J Hand Surg Am 35:109-20
Chung, Kevin C; Haas, Ann (2009) Relationship between patient satisfaction and objective functional outcome after surgical treatment for distal radius fractures. J Hand Ther 22:302-7; quiz 308

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