Article
Variation in surgical fixation rate of wrist fractures in England
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Published: | October 10, 2017 |
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Objectives: Controversy still exists about the best method for treating distal radius fractures. In this study we investigated whether there is variation in fixation rate of distal radius fractures across hospital trusts in England.
Method: Hospital Episode Statistics data from a four year period from April 2009 to March 2013 in England were reviewed. A negative binomial model was constructed to investigate the factors within the trusts which influence surgical fixation rate.
Results: Mean number of total fractures treated surgically per trust was 113 (range 37–269, SD 52.4). 59082 procedures were performed during the study period. Rate of fixation varied from 9.8 to 81.9 patients per 100,000 population between trusts (8.4 fold variation). When the five trusts with the highest rates and the five trusts with the lowest rates are excluded, the range is 16.3–-61.7 per 100,000 population, and the variation is 3.8 fold. Rates of surgical intervention were significantly higher in smaller trusts (p<0.001) and in trusts with a higher population of people aged over 65 years (p<0.001). Social deprivation and number of women in the trust population did not influence fixation rate.
Conclusion: There is wide variation between English hospital trusts in the rate of surgical treatment for distal radius fractures. Larger units have a lower rate of fixation while smaller units and trusts with a higher population of older people have high rates of fixation.