title: Socioeconomic deprivation predicts outcome following radial head and neck fractures.
abstract: BACKGROUND
  There is increasing evidence demonstrating an association between fracture epidemiology and socioeconomic status. However, the influence of socioeconomic deprivation on fracture outcome has not been documented before. The aim of this study was to determine if socioeconomic deprivation influenced the short-term outcome following a fracture of the radial head or neck.
  
  
  METHODS
  We identified from a prospective database all patients who sustained a radial head or neck fracture over an 18-month period. The primary outcome measure for this study was the patient-reported short musculoskeletal function assessment (SMFA). The Index of Multiple Deprivation (IMD) was used to quantify deprivation, and any correlation with functional outcome was determined. Multivariate regression analysis was used to determine the influence of deprivation on outcome once other significant demographic and fracture characteristics had been accounted for.
  
  
  RESULTS
  There were 200 patients in the study cohort, of which 107 (53.5%) were female and the mean age was 44 years (16-83). At a mean follow-up of 6 months the median SMFA score was 0.54 (0-55.4). The SMFA was found to be influenced by the IMD, with increasing deprivation associated with a poorer outcome (p=0.006). On multivariate analysis, the AO fracture classification, compensation and increasing deprivation were the only independent predictors of outcome (all p<0.05).
  
  
  CONCLUSIONS
  We have a shown a clear correlation between functional outcome and socioeconomic status, with the most deprived patients reporting a poorer outcome. Future work should be aimed at determining which aspects of deprivation influence patient outcome, with modifiable factors targeted in future health-care planning.
authors.affiliation: Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SU, UK. andrew.duckworth@yahoo.co.uk
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Duckworth
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Clement
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Jenkins
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Will
authors.forename: Charles M
authors.initials: CM
authors.lastname: Court-Brown
authors.forename: Margaret M
authors.initials: MM
authors.lastname: McQueen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D011203:Poverty; D011379:Prognosis; D011885:Radius Fractures / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult