Assessment of Distal Radius Fracture Complications Among Adults 60 Years or Older

Chung, Kevin C.; Malay, Sunitha; Shauver, Melissa J.; Kim, H. Myra

doi:10.1001/jamanetworkopen.2018.7053

Cited by 71 publications

(85 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many studies have compared surgical methods for displaced DRFs with regard to functional, radiographic and patient-reported outcome measures in a variety of settings and patient groups. While long-term functional and patient-reported outcomes have been shown to be similar between the most frequently used surgical methods [8][9][10][11][12][13][14], the spectrum and frequency of associated complications vary considerably [15][16][17]. It is therefore paramount that physicians treating patients with a displaced DRF are familiar with the complications associated with each treatment method in order to achieve the most favorable outcome.…”

Section: Introductionmentioning

confidence: 99%

Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients

Rundgren

Enocson

Järnbert-Pettersson

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Surgical site infections (SSI) after distal radius fracture (DRF) surgery have not previously been studied as the primary outcome in a large population with comparative data for different surgical methods. The aims of this study were 1) to compare SSI rates between plate fixation, percutaneous pinning and external fixation, and 2) to study factors associated with SSI. Methods We performed a nation-wide cohort study linking data from the Swedish national patient register (NPR) with the Swedish prescribed drug register (SPDR). We included all patients ≥18 years with a registration of a surgically treated DRF in the NPR between 2006 and 2013. The primary outcome was a registration in the SPDR of a dispensed prescription of peroral Flucloxacillin and/or Clindamycin within the first 8 weeks following surgery, which was used as a proxy for an SSI. The SSI rates for the three main surgical methods were calculated. Logistic regression was used to study the association between surgical method and the primary outcome, adjusted for potential confounders including age, sex, fracture type (closed/open), and a dispensed prescription of Flucloxacillin and/or Clindamycin 0–8 weeks prior to DRF surgery. A classification tree analysis was performed to study which factors were associated with SSI. Results A total of 31,807 patients with a surgically treated DRF were included. The proportion of patients with an SSI was 5% (n = 1110/21,348) among patients treated with plate fixation, 12% (n = 754/6198) among patients treated with percutaneous pinning, and 28% (n = 1180/4261) among patients treated with external fixation. After adjustment for potential confounders, the surgical method most strongly associated with SSI was external fixation (aOR 6.9 (95% CI 6.2–7.5, p < 0.001)), followed by percutaneous pinning (aOR 2.7 (95% CI 2.4–3.0, p < 0.001)) (reference: plate fixation). The classification tree analysis showed that surgical method, fracture type (closed/open), age and sex were factors associated with SSI. Conclusions The SSI rate was highest after external fixation and lowest after plate fixation. The results may be useful for estimation of SSI burdens after DRF surgery on a population basis. For the physician, they may be useful for estimating the likelihood of SSI in individual patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients

Rundgren

Enocson

Järnbert-Pettersson

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…We concluded that the complication rate for internal fixation was lower than that of patients receiving casting or an external fixator. 30 In this population-based analysis of ED visits following a DRF fracture, we found that patients receiving internal fixation had lower odds of a DRF-related ED visit compared with other surgical treatment modalities. In addition, we found that the average cost of 30-day DRF-related ED visits and resulting readmissions is $1,340 for surgical patients.…”

Section: Resultsmentioning

confidence: 70%

Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation

Nasser

Chou

Chung

2019

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

show abstract

“…SF-36 and MHQ were chosen as they are validated assessments of overall health and hand-specific disability respectively. [2,27,28] Functional outcomes included assessment of grip strength, wrist and forearm arc of motion at 6 weeks, 3, 6, and 12 months among the two groups. MHQ assessments were performed at the 6-week, 3-, 6-and 12-month time-points, whereas SF-36 was performed at the time of enrollment, 3-, 6-, and 12-months.…”

Section: Study Cohortmentioning

confidence: 99%

Pre-injury activity predicts outcomes following distal radius fractures in patients age 60 and older

et al. 2020

Self Cite

View full text Add to dashboard Cite

Introduction One out of every 5 elderly patients will suffer a distal radius fracture and these injuries are often related to poor bone health. Several surgical subspecialties have demonstrated that pre-injury activity level can impact patient outcomes. To determine the importance of physical activity, we examined the relationship between pre-injury activity and patient-reported and functional outcomes among fracture patients. Methods This is a retrospective analysis of prospectively collected data from participants enrolled in the Wrist and Radius Injury Surgical Trial (WRIST) from April 10, 2012 to December 31, 2016. This study included 304 adults, 60 years or older with isolated unstable distal radius fractures; 187 were randomized to one of three surgical treatments and 117 opted for casting. Participants opting for surgery were randomized to receive volar locking plate, percutaneous pinning, or external fixation. Participants who chose not to have surgery were treated with casting. All participants were stratified prior to analysis into highly and less-active groups based on pre-injury Rapid Assessment of Physical Activity Scores. Results 280 patients had 12-month assessments of outcomes. Highly active participants scored 8 and 5 points greater on the Michigan Hand Questionnaire at 6 weeks and 3 months respectively, p<0.05. Highly active participants demonstrated greater grip strength at the 3-month (p = 0.017) and 6-month (p = 0.007) time-points. Highly active participants treated with volar

show abstract

Assessment of Distal Radius Fracture Complications Among Adults 60 Years or Older

Cited by 71 publications

References 40 publications

Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients

Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients

Thirty-day Emergency Department Utilization after Distal Radius Fracture Treatment: Identifying Predictors and Variation

Pre-injury activity predicts outcomes following distal radius fractures in patients age 60 and older

Contact Info

Product

Resources

About