National Surgical Trends in Distal Radius Fixation in Medicare Beneficiaries: Increased Utilization by Plastic Surgeons and Hand Surgeons

Introduction: Several randomized controlled trials have been published concerning the treatment of distal radius fracture interventions (DRFIs) in elderly patients. This study aims to investigate the surgical trends in the management of DRFs within the Medicare population. Methods: In this retrospective study, we collected data from the Centers for Medicare and Medicaid Services between 2013 and 2022 for claims for DRFIs identified using Current Procedural Terminology codes 25606, 25607, 25608, and 25609. Results were categorized by primary operator type (general orthopaedic surgeon, general plastics, general surgeon, subspecialty hand surgeon) and place of service (inpatient, outpatient, other). Results: A total of 101,857 DRFIs were identified. The overall rate of DRFIs declined by 12% (29.5 to 26.1 per 100,000 individuals). The utilization of closed reduction percutaneous pinning experienced a 63% decrease (4.8 to 1.8 per 100,000). Conversely, open treatment for distal radial intra-articular fractures saw an 11% increase in utilization (10.0 to 11.1 per 100,000). Orthopaedic surgeons and general surgeons experienced a notable decrease in utilization of DRFIs of 22% and 6%, respectively, whereas plastic surgeons and hand surgeons saw an increase in utilization of 74% and 13%, respectively, over the same 10-year period. Outpatient DRFIs increased by 11%, whereas inpatient and other decreased by 17% and 36%, respectively. Conclusion: There has been a notable decline in DRFIs within the Medicare population. We observed a diminishing procedure share among general orthopaedic surgeons and general surgeons, accompanied by a rising utilization of plastic surgeons and hand surgeons in addressing DRFIs. Level of Evidence: NA, Database Review.