Abstract
Introduction
Racial and ethnic disparities have been noted in multiple orthopedic subspecialties,
and recent literature have suggested disparities in distal radius fracture (DRF) treatment
based on race/ethnicity in Medicare patients. This study sought to assess for racial
and ethnic disparities in DRF care in adult patients of all age groups using a national
database.
Materials and Methods
The National Surgical Quality Improvement Program (NSQIP) database was utilized to
identify all patients undergoing DRF fixation between 2007 and 2020. Adult patients
were identified using current procedural terminology (CPT) codes. The distribution
of operative fixation by race/ethnicity was compared with the United States census
data from 2016. Complication rates between White and non-White patients were compared
using multivariate logistic regression applied to propensity score–matched cohorts.
Results
Among the 21,680 operatively treated DRFs identified, a higher proportion of patients
were White compared with non-White patients, when compared with US census data (90%
vs. 76.1%, p = 0.03). There was a significant difference in the racial distribution of operatively
treated DRFs between non-geriatric and geriatric cohorts (p < 0.005). There were no significant differences observed in rates of complications,
readmissions, or reoperations between propensity score–matched cohorts of White and
non-White patients (p > 0.05).
Conclusion
Consistent with prior studies on Medicare patients, this database review demonstrates
a lower rate of DRF fixation in racial or ethnic minority patients of all adult age
groups. This disparity worsened among geriatric patients. These data are relevant
for those providing DRF care to help identify and mitigate race and/or ethnicity-based
disparities.
Keywords
distal radius fracture - geriatric fracture - racial disparities
