title: Variation in the Use of Therapy following Distal Radius Fractures in the United States.
abstract: BACKGROUND
  Distal radius fractures (DRFs) are one of the most common injuries among the elderly, resulting in significant expense and disability. The specific aims of this study are (1) to examine rates of therapy following DRFs and (2) to identify those factors that influence utilization of therapy and time span between DRF treatment and therapy among a national cohort of elderly patients.
  
  
  METHODS
  We examined national use of physical and occupational therapy among all Medicare beneficiaries who suffered DRFs between January 1, 2007, and October 1, 2007, and assessed the effect of treatment, patient-related, and surgeon-related factors on utilization of therapy.
  
  
  RESULTS
  Overall, 20.6% of patients received either physical or occupational therapy following DRF. Use of therapy varied by DRF treatment, and patients who underwent open reduction and internal fixation were more likely to receive therapy compared with patients who received closed reduction. Patients who received open reduction and internal fixation were also referred to therapy earlier compared with patients who received external fixation, percutaneous pinning, and closed reduction. Surgeon specialization is associated with greater use of postoperative therapy. Patient predictors of therapy use include younger age, female sex, higher socioeconomic status, and fewer comorbidity conditions.
  
  
  CONCLUSIONS
  Use of therapy following DRF varies significantly by both patient- and surgeon-related factors. Identifying patients who benefit from postinjury therapy can allow for better resource utilization following these common injuries.
authors.affiliation: Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, Mich.; and Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Waljee
authors.affiliation: Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, Mich.; and Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, Mich.; and Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Melissa
authors.initials: M
authors.lastname: Shauver
authors.affiliation: Department of Surgery, Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, Mich.; and Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung