American Academy of Orthopaedic Surgeons Appropriate Use Criteria: Treatment of Distal Radius Fractures

Abstract

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria for the Treatment of Distal Radius Fractures . Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to determine the appropriateness of various treatments in the management of distal radius fractures. The Appropriate Use Criteria for the Treatment of Distal Radius Fractures were derived by identifying clinical indications typical of patients with a distal radius fracture in clinical practice. These indications were most often variables observable by the clinician, including symptoms or results of diagnostic tests. In addition, "patient-level variables" (eg, activity level or demographics) can be considered. In total, 2,160 patient scenarios and 9 treatments were developed by the writing panel, a group of clinicians who are specialists in this Appropriate Use Criteria topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as "appropriate" (median rating, 7 to 9), "may be appropriate" (median rating, 4 to 6), or "rarely appropriate" (median rating, 1 to 3).