The American Academy of Orthopaedic Surgeons Appropriate Use Criteria on the Treatment of Distal Radius Fractures

2014 ◽  
Vol 96 (2) ◽  
pp. 160-161 ◽  
Keyword(s):  
American Academy ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Radius Fractures ◽  
Orthopaedic Surgeons

Applicability of the AAOS appropriate-use criteria for distal radius fractures in surgical practice

2017 ◽  
Vol 42 (1) ◽  
pp. 197-202 ◽  
Author(s):  
Talal Ibrahim ◽  
Osama M. S. Aldahamsheh ◽  
Abdelsalam Hegazy ◽  
Hassan M. K. Ghomrawi
Keyword(s):  
Distal Radius ◽  
Distal Radius Fractures ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Radius Fractures ◽  
Surgical Practice

scholarly journals Distal Radius Fractures: AAOS Appropriate Use Criteria versus Actual Management at a Level One Trauma Center

2015 ◽  
Vol 40 (9) ◽  
pp. e6-e7 ◽  
Author(s):  
James C. Kyriakedes ◽  
Eugene Tsai ◽  
Charles Yu ◽  
Harry A. Hoyen ◽  
Kevin James Malone ◽  
...  
Keyword(s):  
Distal Radius ◽  
Trauma Center ◽  
Distal Radius Fractures ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Radius Fractures

Treatment Patterns for Distal Radius Fractures Before and After Appropriate Use Criteria Adoption

Hand ◽  
2020 ◽  
pp. 155894472097514
Author(s):  
Richard Samade ◽  
Omar Zaki ◽  
Nolan Farrell ◽  
Nicholas Farrar ◽  
Kanu S. Goyal
Keyword(s):  
Operative Treatment ◽  
Distal Radius ◽  
High Energy ◽  
Distal Radius Fractures ◽  
Statistical Testing ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Radius Fractures ◽  
Radiographic Measurements ◽  
Before And After

Background The purpose of this study was to determine agreement with the American Academy of Orthopaedic Surgery Appropriate Use Criteria (AUC) for distal radius fractures (DRFs), before and after their adoption, and secondarily determine predictors of operative management. Methods A single-institution retrospective cohort study comparing patients treated either nonoperatively (115 patients) or operatively (767 patients) for DRFs between May 1, 2008, and May 1, 2018, by 8 hand surgeons was performed. Data included demographics, injury characteristics, DRF radiographic measurements, treatment rendered, and their appropriateness according to the AUC. Statistical testing used the Fisher and χ2 tests, t test, and multiple variable logistic regression, with a significance level of .05. Results Overall, there was a significant increase in AUC agreement for operatively treated DRFs (82.7%-89.3%, P = .01), but no difference in agreement for nonoperatively treated DRFs (12.5%-10.7%, P = .77). Age <80 years, AO classes other than B, intra-articular displacement >1 mm, radial inclination <18°, high-energy mechanism of injury, and greater than 1 week to treatment were independent predictors of operative treatment. The area under the curve for the validated regression model using the aforementioned predictors was 0.82. Conclusion Agreement with AUC for DRFs increased after its adoption for operatively treated, but not for nonoperatively treated, fractures. In addition, a predictive model for operative treatment was developed and validated. Future studies may benefit from further model refinement and testing in other patient cohorts.

scholarly journals Distal Radius Fractures: AAOS Appropriate Use Criteria Versus Actual Management at a Level I Trauma Center

Hand ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 209-214 ◽  
Author(s):  
James C. Kyriakedes ◽  
Eugene Y. Tsai ◽  
Douglas S. Weinberg ◽  
Charles C. Yu ◽  
Harry A. Hoyen ◽  
...  
Keyword(s):  
Distal Radius ◽  
Trauma Center ◽  
Nonoperative Treatment ◽  
Distal Radius Fractures ◽  
Type B ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Radius Fractures ◽  
Actual Treatment ◽  
Level I

Background: The aim of this study is to determine whether the American Academy of Orthopaedic Surgeons’ (AAOS) Appropriate Use Criteria (AUC) for distal radius fractures correlates with actual treatment by orthopedic hand surgeons at a level I trauma center. Methods: ICD-9 codes were used to retrospectively identify patients who presented with wrist fractures over 1 year. Patients with isolated distal radius fractures were evaluated using the AAOS AUC application for distal radius fractures. Actual treatment was then compared with treatment recommended by the AUC. Results: Of the 112 patients, 64 (57%) received treatment that matched the AAOS AUC recommendation as an “appropriate treatment.” Actual management matched the AUC recommendation 100%, 7%, and 50% of the time, for Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type A, B, and C fractures, respectively. Surgery was performed for type A, B, and C fractures 30%, 7%, and 50% of the time, respectively. For type B fractures, only the 2 cases that were managed operatively were in agreement with the AUC. For type C fractures, increased patient age (57 years and older) was significantly associated with nonoperative treatment decisions. Surgeon decisions for nonoperative treatment were in agreement with the AUC recommendations 40% of the time, whereas surgeon decisions for surgery matched the AUC recommendations 97% of the time. Conclusions: We found low agreement between actual treatment decisions and the AUC-recommended “appropriate” treatments, especially for the type B and C fractures that were managed nonoperatively. The AUC favors surgery for all intra-articular fractures, while we emphasized age and fracture displacement in our decision-making process.

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