Incidence of Corrective Procedures After Nonoperatively Managed Distal Radius Fractures in the Elderly.

Although the majority distal radius fractures in the elderly are initially managed nonoperatively, the true incidence of subsequent corrective surgery is unknown. The purpose of this study was to determine the incidence and predictors of corrective surgery after conservative management. METHODS: ICD-9 and Current Procedural Terminology codes were queried from the Medicare 5% sample to select patients aged 65 years and older undergoing nonsurgical treatment of distal radius fractures with a minimum 5-year follow-up. Rates of subsequent ipsilateral wrist surgery were correlated against patient age, sex, geographic region, and initial closed reduction. RESULTS: Five thousand eighty patients with a mean age of 78.3 years were included. Fifty-five patients (1.1%) had undergone subsequent wrist surgery at a median time of 182 days after injury. The youngest cohort (65 to 69 years) had a significantly higher operation rate (1.9%, P = 0.007) than the oldest cohort (80+ years) (0.5%, P = 0.004). There was no notable difference in corrective procedures between sex, geographic region, and initial closed reduction. DISCUSSION: Once surgical intervention is deemed unnecessary per standard guidelines, the data support successful nonsurgical management in a large majority of patients but highlight a small subset of younger patients who remain at increased risk of requiring additional surgery.

Judgments of self-identified gay and heterosexual male speakers: Which phonemes are most salient in determining sexual orientation?

While numerous studies have demonstrated that a male speaker's sexual orientation can be identified from relatively long passages of speech, few studies have evaluated whether listeners can determine sexual orientation when presented with word-length stimuli. If listeners are able to distinguish between self-identified gay and heterosexual male speakers of American English, it is unclear whether they form their judgments based on a phoneme, such as a vowel or consonant, or multiple phonemes, such as a vowel and a consonant. In this study, we first found that listeners can distinguish between self-identified gay and heterosexual speakers of American English upon hearing word-length stimuli. We extended these results in a separate experiment to demonstrate that listeners primarily rely on vowels, and to some extent consonants, when forming their judgments. Listeners were able to differentiate between the two groups of speakers for each of the vowels and three of the seven consonants presented. In a follow-up experiment we found evidence that listeners' judgments improved if they were presented with multiple phonemes, such as a vowel and /s/. These results provide important information about how different phonemes can provide discriminant information about a male speaker's sexual orientation.