Significant Change in the Surgical Treatment of Distal Radius Fractures: A Nationwide Study Between 1998 and 2008 in Finland

Abstract

Studies from the United States report a large increase in the surgical treatment of distal radius fractures with open reduction and internal fixation using locked plates. The aim of the present study was to determine whether the same trend has occurred in a Scandinavian country by assessing the number, incidence, and surgical methods of all surgically treated distal radius fractures in Finland over a recent 11-year period. The study covered the whole adult population (aged >19 years) in Finland during the 11-year period from January 1, 1998, to December 31, 2008. Data on surgically treated distal radius fractures were obtained from the nationwide National Hospital Discharge Registry. During the 11-year study period, a total of 14,514 surgical operations (external fixation, percutaneous pinning, or plating) for adult distal radius fractures were performed in Finland. There was a dramatic shift toward internal fixation with plating; the incidence and number of platings more than doubled between 2006 and 2008. The incidence and number of external fixations decreased correspondingly. Percutaneous pinning was used in 13% of the surgical procedures during the study period. A striking shift from external fixation to plating in the treatment of distal radius fractures has occurred in Finland over the past few years, despite the fact that the scientific literature does not support plating over external fixation. In addition, the incidence and number of surgeries for distal radius fractures doubled between 1998 and 2008. The reasons for these changes are not known.