Diabetes mellitus effect on rates of perioperative complications after operative treatment of distal radius fractures

Abstract

Purpose This study focuses on distal radius fractures that require surgical treatment. Patients with diabetes mellitus (DM) are at increased risk of bone fracture despite normal areal bone mineral density. The aim of this study is to identify the impact of DM on perioperative complications for patients undergoing operative treatment of distal radius fracture. Methods A retrospective cohort study was conducted using data collected through the National Surgical Quality Improvement Program database. All patients who underwent operative treatments for distal radius fractures from 2007 through 2018 were identified. Data collected include demographic information, comorbidities, and complications occurring within 30 days of initial surgical intervention. The incidence of adverse events following surgery was evaluated with univariate and multivariate analyses where appropriate. Results Patients with DM were found to have a low rate of complications postsurgical repair of distal radius fractures. Preoperative comorbidity analysis showed that the diabetic group had significantly higher rates of chronic obstructive pulmonary disease, hypertension, congestive heart failure, renal failure, steroid use, bleeding disorders, dyspnea, and poorer functional status. Diabetes was found to be an independent predictor for unplanned intubation, sepsis, and septic shock. Diabetes was not found to be an independent predictor of other postoperative complications. Conclusion Complications after surgical repair of distal radius fracture are low except when it comes to reintubation, sepsis, and septic shock. While the risks of independent complications remain relatively low, diabetes remains an important factor to consider when selecting surgical candidates and to ensure appropriate pre-operative risk assessment.

Surgical site infection following surgery for hand trauma: a systematic review and meta-analysis

“…This subgroup analysis is biased by very large, retrospective registry studies, which are unreliable for detecting SSI because they rely solely on valid recording and coding (Leaper et al, 2013;Smyth and Emmerson, 2000). Looking at the largest included studies, the SSI risk ranges from 0.1% to 2.3% in studies with over 10,000 participants (Constantine et al, 2022;Galivanche et al, 2021;Mahmood Wei et al, 2021). These four studies are all on distal radial fracture fixation, mostly ORIF, and all are retrospective.…”

The Effect of Obesity on Distal Radius Fractures: An Analysis from the NSQIP Database

“…Wei et al conducted a retrospective review of 11,272 patients and found that increased operation time was associated with increased risk of reoperation following DRF repair ( P < 0.001). 32 They suggested that resident training and inexperience was the main catalyst for this effect. Our study suggests that BMI is associated with this phenomenon, as increased BMI was associated with both longer operation times and increased reoperation rates in our analysis.…”

Risk Factors for 30-Day Complications and Unplanned Reoperation Following Surgical Treatment of Distal Radius Fractures

“…30,31 Previous studies evaluating diabetes as a risk factor following DRF surgery demonstrated polarity in outcomes with one report indicating increased complications and another reporting minimal effect on complications. 32,33 report's finding that diabetes approaches but does not meet significance (P = .09) may be reflective of this discrepancy. In addition, BMI approached but did not meet significance (P = .086) on multivariate analysis.…”