Distal radius fractures are associated with high burden for healthcare services and individuals. This study aims to describe epidemiology of hospital admitted patients with distal radius fractures in, Portugal from 2000–2014 and evaluate treatment patterns.

We included all patients admitted to public health service hospitals from 2000–2014, identified with ICD9-CM codes. Treatments were tracked using ICD9 codes. Patients were categorized according to age (young- <18y, adult- 18–64y; elderly- >65y), gender, year, fracture and treatment.

In total, 23,964 patients were included, mean age 41.65y, with significantly more male in the overall (56.9%, P<0.001), young (78.2%, P<0.001) and adult groups (64.5%, P<0.001); and more females in the elderly (82.7%, P<0.001). Affected men from the young group were younger than women (P<0.001), but older in both adult and elderly groups (P<0.001). Logistic regressions on effect of gender and age on the likelihood of open fracture (OF) and open reduction (OR) – men are less likely to have OF (0.572 times) and OR (0.691 times), and increasing age is associated with increased likelihood of OF and OR. There was a tendency to an increase in the overall number of fractures with time (1912 in 2014 vs 1476 in 2000, P<0.001). OF account for 4.3% of all fractures. Adult had 1.91 times higher odds and elderly 1.87 to OF than young. No time-based tendency was found. Closed reduction (CR) was significantly more common than OR (P<0.001), independently of age groups (all P<0.001). Adult and elderly patients had respectively, 5.49 and 3.50 times higher odds to have an OR than younger. Men and women had similar probability of an OR (P=0.121). CR with internal fixation (IF), was more common than OR with IF (35.6% vs 28%, P<0.001). ORIF and CRIF use increased in the last years with a decrease on CR without IF; OR choice is increasing, with CR use showing a stable tendency. Other fractures were present in 25.1%. In total, 18.7% had only one associated fracture, 42% of these in lower limb. Mean hospital stay was 6.06days, higher with OR and OF (P<0.001). Regression analysis showed each added fracture resulted in increase of 7.33days.

Distal radius fractures are increasing, affecting predominantly young and adult men and old women. We observed a tendency for an increasing use of ORIF, as shown by other recent series. Associated lesions have an important impact on outcomes.