A Clinical Trial for the Surgical Treatment of Elderly Distal Radius Fractures

a MiCDA Research Project Description

Investigators: Adeyiza Momoh, Kevin Chi Chung, Elham Mahmoudi

Funding: National Institute Of Arthritis And Musculoskeletal And Skin Diseases, 2015-2016 (3 R01 AR 062066 04 S1)

Over 300,000 distal radius fractures (DRFs) occur among those 65 and older per year in the United States. Because this injury results in over $210 million in Medicare spending on treatment, finding an optimal clinical and economical treatment option is an important health and policy issue. Despite over 200 years of experience in treating DRF, little is known about the comparative effectiveness of various DRF treatment options among the older population. Close reduction and casting is a nonsurgical technique that is frequently used. However, with a high frequency of collapse and displacement, this treatment option may not be the most appropriate one for older individuals. The three surgical techniques for DRF treatment are percutaneous pinning, external fixation, and internal fixation with volar locking plating. Initial evidence has shown that locking plate fixation can permit older patients to move their hands and wrists much sooner and return to activities more quickly.
The parent grant for this supplement is a randomized controlled clinical trial to study the comparative effectiveness of each of the three surgical procedures compared with the non-surgical procedure. The proposed supplement aims to incorporate a young and promising surgeon in this research project and provide the essential education and mentoring to promote his academic career. We anticipate this experience will result in the submission of an R03 proposal, using large national datasets, to further investigate racial/ethnic variations in DRF?s initial treatment, complication rates, post-acute settings, and healthcare costs. This diversity supplement will not only contribute to the literature by advancing our understanding of variations in DRF treatment and their corresponding healthcare costs, but it will also provide the best mechanism to mentor and engage a young academic surgeon.

Research Signature Theme:

Health and well-being in later life: Disability

Country of Focus: USA