• R Smektala, H G Endres, B Dasch, F Bonnaire, H J Trampisch, and L Pientka.
• Chirurgische Universitätsklinik, Abteilung für Unfallchirurgie, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum. ruediger.smektala@rub.de
• Unfallchirurg. 2009 Jan 1; 112 (1): 46-54.

BackgroundThis study is the first to document the quality of inpatient care provided to elderly patients with distal radius fracture in Germany.Patients And MethodsInpatient care provided to 1,201 patients age 65 or older with isolated distal radius fracture was documented in a prospective cohort study conducted at 242 acute care clinics in Germany between January 2002 and September 2003.ResultsThe median patient age was 75, and nearly 90% of patients were female. Approximately 71% of patients were classified as ASA I or II, and 28% were ASA III. The most common comorbidity was arterial hypertension (60%). Seventy-five percent of patients were admitted on the day of the accident; of these, 63% had surgery on the same day, and 20% on the following day. The primary form of anaesthesia was general anaesthesia (55%). The predominant fracture management procedure was percutaneous K-wire osteosynthesis (56% of cases), followed by plate osteosynthesis (44%). The length of hospital stay after plate osteosynthesis (median 8.5 days) was more than twice as long as after K-wire osteosynthesis (median 4 days). The rate of postoperative complications typical of each procedure was around 10%. Roughly 90% of patients were discharged to home. Although evidence of osteoporosis was observed in 62% of women and 50% of men, only 7.9% of patients were prescribed osteoporosis-specific medication.ConclusionsUnexpected findings were the predominance of general anaesthesia and percutaneous K-wire osteosynthesis. Osteoporosis, affecting a majority of elderly women, is neglected in clinical practice. Good quality of care is reflected by the low rate of complications.

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