Conservatively treated distal radius fractures. Who is referred?

Abstract

This was a retrospective review of 394 patients with distal radius fractures referred to hand therapy from a fracture clinic service provided by a 24 hr acute medical care facility. Only those fractures treated conservatively with closed reduction and cast immobilisation were included. Age, gender, and the number of treatments received prior to discharge from hand therapy were identified, as well as whether patients received hand therapy treatment alone or if they were referred for specialist opinion. Men with conservatively managed distal radius fractures received significantly less treatment than women (rate ratio 0.67; 95% confidence interval [0.60–0.75]; p < 0.001) and there was a significant difference between the number of treatments received by those who were referred to a specialist and those who were not (p < 0.001). Both genders received an increasing number of treatments with age, with a peak in the number of treatments for patients aged 40–60 years, followed by decline. Global trends of an ageing population signal that the incidence of distal radius fracture will continue to increase. The findings of this study suggest relatively low rehabilitation timeframes and treatment numbers for uncomplicated, conservatively managed fractures. Results give some insight as to which patients are accessing rehabilitation post distal radius fracture but further research is warranted to understand the criteria that trigger referral to hand therapy and how best to provide equitable care for men.