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Unfallchirurg. 2009 Jan;112(1):46-54. doi: 10.1007/s00113-008-1523-8.

[Quality of care after distal radius fracture in Germany. Results of a fracture register of 1,201 elderly patients].

[Article in German]

Author information

1
Chirurgische Universitätsklinik, Abteilung für Unfallchirurgie, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum. ruediger.smektala@rub.de

Abstract

BACKGROUND:

This study is the first to document the quality of inpatient care provided to elderly patients with distal radius fracture in Germany.

PATIENTS AND 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.

PMID:
19104764
DOI:
10.1007/s00113-008-1523-8
[Indexed for MEDLINE]
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