title: Differences in the Treatment of Distal Radius Fractures by Hand Fellowship Trained Surgeons: A Study of ABOS Candidate Data.
abstract: OBJECTIVE
  The management of distal radius fractures differs based on the nature of the fracture and the experience of the surgeon. We hypothesized that patients requiring surgical intervention would undergo different procedures when in the care of a surgeon with subspecialty training in hand surgery as compared with surgeons with no subspecialty training in hand surgery.
  
  
  METHODS
  We queried the ABOS database for case log information submitted for part II of the ABOS examination. Queries for all codes involved with distal radius fracture management were combined with associated codes for the management of median nerve neuropathy, triangular fibrocartilage complex tears, ulnar shaft, and styloid fractures. Hand fellowship trained orthopedic surgeons were compared with those completing other fellowships and non-fellowship trained orthopedic surgeons during their board collection period.
  
  
  RESULTS
  During the study period, 2,317 orthopedic surgeons reported treatment of 15,433 distal radius fractures. Of these surgeons, 411 had hand fellowship training. On a per surgeon basis, fellowship trained hand surgeons operatively treated more multifragment intra-articular distal radius fractures than their non-hand fellowship trained counterparts (5.3 vs 1.2). Additional procedures associated with the management of distal radius fractures were also associated with the fellowship training of the treating surgeon.
  
  
  CONCLUSIONS
  Among orthopedic surgeons taking part II of the ABOS certifying examination, differences exist in the type, management, and reporting of distal radius fractures among surgeons with different areas of fellowship training.
  
  
  CONCLUSIONS
  This study describes the association of hand surgery fellowship training on the choice of intervention for distal radius fractures and associated conditions.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
authors.forename: Sean
authors.initials: S
authors.lastname: Childs
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
authors.forename: Tobias
authors.initials: T
authors.lastname: Mann
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
authors.forename: Jason
authors.initials: J
authors.lastname: Dahl
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
authors.forename: John
authors.initials: J
authors.lastname: Ketz
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
authors.forename: Warren C
authors.initials: WC
authors.lastname: Hammert
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Murray
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY. Electronic address: openelfar@gmail.com.
authors.forename: John
authors.initials: J
authors.lastname: Elfar
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000193:education*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome; D014481:United States
keywords: Distal radius; population outcomes; specialty training