title: Determinants of distal radius fracture management in polytrauma patients.
abstract: BACKGROUND
  Over 640,000 distal radius fractures occur annually in the United States. No studies have been performed looking specifically at polytrauma patients who sustain distal radius fractures. We sought to determine variables affecting management of distal radius fractures in polytrauma patients.
  
  
  METHODS
  An IRB-approved review of trauma patients from 2008-2011 was performed. Records for patients with distal radius fractures were examined, assessing age, gender, Glascow Coma Score, Injury Severity Score, mechanism, type, and characteristics of injury, as well as operative repair. A logistic regression was performed using SPSS 15.0.
  
  
  RESULTS
  The database identified 12,054 patients, 434 sustaining a distal radius fracture. No statistically significant difference in operative repair based on mechanism of injury (p = 0.465) was identified. A total of 285 patients (65.7 %) underwent surgery for distal radius fractures. In univariate analysis, younger age was the only statistically significant demographic predictor of surgical intervention (p = 0.003). In both univariate analysis and logistic regression, open, intra-articular, displaced, and comminuted fractures, as well as those with concomitant ulna fractures were statistically significantly associated with operative repair. Fracture displacement was the most likely variable to be associated with surgical intervention (OR = 12.761, 95 % CI[7.219, 22.556]) (p < 0.001).
  
  
  CONCLUSIONS
  In polytrauma patients, surgery for distal radius fractures is associated with younger age, open, intra-articular, displaced, and comminuted fractures, as well as concomitant ulna fractures. Displaced fractures were almost 13 times more likely to undergo surgical intervention than non-displaced fractures. Gender and mechanism of injury are not predictive of surgical intervention.
authors.affiliation: Department of Surgery, Division of Plastic Surgery, Lehigh Valley Health Network, Cedar Crest & I-78, P.O. Box 689, Allentown, PA 18105-1556 USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Adkinson
authors.affiliation: Department of Surgery, Division of Plastic Surgery, Lehigh Valley Health Network, Cedar Crest & I-78, P.O. Box 689, Allentown, PA 18105-1556 USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Soltys
authors.affiliation: Drexel University College of Medicine, Philadelphia, PA USA.
authors.forename: Nathan F
authors.initials: NF
authors.lastname: Miller
authors.affiliation: Department of Community Health and Health Studies, Lehigh Valley Health Network, Allentown, PA USA.
authors.forename: Sherrine M
authors.initials: SM
authors.lastname: Eid
authors.affiliation: Department of Surgery, Division of Plastic Surgery, Lehigh Valley Health Network, Cedar Crest & I-78, P.O. Box 689, Allentown, PA 18105-1556 USA.
authors.forename: Robert X
authors.initials: RX
authors.lastname: Murphy
keywords: Distal radius fractures; Polytrauma; Surgery