Trends in Management of Radial Head and Olecranon Fractures
Matthew Motisi1, Jennifer Kurowicki2, Derek D. Berglund2, Jacob J. Triplet3, Shanell Disla2, Timothy Niedzielak4, Jonathan C. Levy2, *
1 Broward Health Medical Center, 1800 NW 49th Street Fort Lauderdale, FL 33309, USA
2 Holy Cross Orthopedic Institute, 5597 N. Dixie Highway Fort Lauderdale, FL 33334, USA
3 Doctors Hospital- Ohio Health, 5100 West Broad Street, Columbus, OH 43228, USA
4 Nova Southeastern University, College of Osteopathic Medicine, 3301 College Avenue Fort Lauderdale, FL 33314, USA
Advancement in surgical techniques and implants has improved the ability to manage radial head and olecranon fractures. However, trends in management of these fractures are largely unstudied.
This purpose of this study is to evaluate management trends for these common fractures.
A retrospective review of a comprehensive Humana database was performed using Pearl Diver supercomputer (Warsaw, IN, USA) for radial head and neck (RHNF) and olecranon fractures (OF) between 2007 and 2014. Treatment methods including open reduction internal fixation (ORIF), radial head arthroplasty (RHA), and non-operative treatment were reviewed. Total reported incidence of office visits and utilization of each treatment modality were investigated. Sub-analysis with stratification by age 15-74 and greater than 75-years was performed for OF.
A total of 10,609 OF and 20,400 RHNF were identified between 2007 and 2014. A significant trend increase in the annual incidence of RHNF (266 cases/year, p<0.001) and OF (133.9 cases/year, p=0.001) was observed. A significant trend increase in annual percent utilization of RHA (0.22% per year, p=0.011) and a significant trend decrease in the annual percent utilization of ORIF (-1.0% per year, p=0.004) and non-operative management (-0.53% per year, p=0.046) was observed for RHNF. A significant trend increase was observed in percent utilization (0.40% per year, p=0.022) for OF non-operative management, especially in patients over 75 years (66% per year, p=0.034).
The percentage of patients being treated with RHA is increasing. Non-operative management of OF has increased, specifically in the patients who are over 75 years.
Keywords: Elbow fracture management, Non-operative management, Olecranon fracture, Open reduction internal fixation, Radial head arthroplasty, Radial head fracture, Radial neck fracture.
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* Address correspondence to this author at the Holy Cross Orthopedic Institute, 5597 N. Dixie Highway Fort Lauderdale, FL 33334, USA; Tel: (954 489-4579), Fax: (954) 229-8698; Email: firstname.lastname@example.org