[Quality of care after distal radius fracture in Germany. Results of a fracture register of 1,201 elderly patients].
BACKGROUND
This study is the first to document the quality of inpatient care provided to elderly patients with distal radius fracture in Germany.


METHODS
Inpatient care provided to 1,201 patients age 65 or older with isolated distal radius fracture was documented in a prospective cohort study conducted at 242 acute care clinics in Germany between January 2002 and September 2003.


RESULTS
The median patient age was 75, and nearly 90% of patients were female. Approximately 71% of patients were classified as ASA I or II, and 28% were ASA III. The most common comorbidity was arterial hypertension (60%). Seventy-five percent of patients were admitted on the day of the accident; of these, 63% had surgery on the same day, and 20% on the following day. The primary form of anaesthesia was general anaesthesia (55%). The predominant fracture management procedure was percutaneous K-wire osteosynthesis (56% of cases), followed by plate osteosynthesis (44%). The length of hospital stay after plate osteosynthesis (median 8.5 days) was more than twice as long as after K-wire osteosynthesis (median 4 days). The rate of postoperative complications typical of each procedure was around 10%. Roughly 90% of patients were discharged to home. Although evidence of osteoporosis was observed in 62% of women and 50% of men, only 7.9% of patients were prescribed osteoporosis-specific medication.


CONCLUSIONS
Unexpected findings were the predominance of general anaesthesia and percutaneous K-wire osteosynthesis. Osteoporosis, affecting a majority of elderly women, is neglected in clinical practice. Good quality of care is reflected by the low rate of complications.
Smektala
R
R
Chirurgische Universitätsklinik, Abteilung für Unfallchirurgie, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum. ruediger.smektala@rub.de
Endres
H G
HG
Dasch
B
B
Bonnaire
F
F
Trampisch
H J
HJ
Pientka
L
L
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011182:Postoperative Care / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011885:Radius Fractures / Q000453:epidemiology* / Q000601:surgery*; D012042:Registries; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000453:epidemiology* / Q000601:surgery*