Elevated BMI is associated with intra-articular comminution, prolonged operative time, and postoperative complications in distal radius fractures

Goodloe, J. Brett; Traven, Sophia A.; Herzog, Leah; Richardson, Chad M.; Daley, Dane N.; Slone, Harris S.

doi:10.1016/j.injury.2020.08.006

Cited by 10 publications

(16 citation statements)

References 32 publications

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“…However, the effect of surgery is affected by many factors, and there are many complications after surgery. erefore, analyzing the relevant factors that affect the postoperative recovery of patients with distal radius fractures can help improve the prognosis of surgical treatment and reduce the incidence of complications [10][11][12]. is study retrospectively analyzed the clinical data of 50 patients with distal radius fractures admitted to our hospital, observed their complications, and analyzed related factors that affect the postoperative prognosis of the patients.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Postoperative Complications and Related Factors Affecting Prognosis in 50 Patients with Distal Radius Fractures

Yuan

Wang

Lü

2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To explore the postoperative complications of distal radius fractures and analyze the related factors that affect its prognosis. Methods. The clinical data of 50 patients with distal radius fractures admitted to our hospital from October 2016 to September 2019 were retrospectively analyzed. All patients were followed up for 6–12 months, and their postoperative complications were recorded. Collect general patient information and related clinical data. During the follow-up process, Gartland and Werley wrist function scoring system was used to evaluate the prognosis of patients’ joint function. Univariate analysis and multiple logistic regression models were used to analyze the related factors that affected the prognosis of patients. Results. 15 patients with postoperative complications were found during the follow-up period, with an incidence rate of 30.00%. Univariate analysis showed that the patient’s age, cause of injury, AO classification, shortened deformity, whether it was osteoporosis, surgical method, whether it was combined with other fractures on the same side, whether it was comminuted fracture, and the time to start postoperative exercise were all related to the distal radius. The prognosis of fractures is related ( P < 0.05 ). Multivariate logistic analysis showed that age, AO classification, surgical method, whether it was combined with other fractures on the same side, whether it was comminuted fracture, and the time to start postoperative exercise were the independent factors affecting the prognosis of distal radius fractures ( P < 0.05 ). Conclusion. The postoperative complications of distal radius fractures are higher. The prognosis is related to the patient’s age, AO classification, surgical method, whether it is combined with other fractures on the same side, whether it is comminuted fracture, and the time to start postoperative exercise. Therefore, choosing an appropriate surgical method and starting exercise in time can effectively improve the recovery of the patient’s wrist function and reduce the occurrence of complications.

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Section: Introductionmentioning

confidence: 99%

Analysis of Postoperative Complications and Related Factors Affecting Prognosis in 50 Patients with Distal Radius Fractures

Yuan

Wang

Lü

2021

Evidence-Based Complementary and Alternative Medicine

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“…Moreover, patients are trending toward a higher BMI, which has been associated with 30-day complications and revision surgery after distal radius fracture ORIF. 24 During the same period, data from CDC show increasing average BMI in the general US population, suggesting that we are treating an increasing proportion of obese patients over the past decade. 25 We observed a trend toward higher proportions of presentation with sepsis physiology and more severe wound classifications among patients undergoing distal radius fracture ORIF.…”

Section: Discussionmentioning

confidence: 99%

Ten-year National Trends in Patient Characteristics and 30-day Outcomes of Distal Radius Fracture Open Reduction and Internal Fixation

Zhang¹,

Dyer²,

Earp³

et al. 2022

JAAOS Glob Res Rev

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Introduction: Despite increased utilization, recent temporal trends in patient comorbidities and episode-of-care outcomes for distal radius fracture open reduction and internal fixation (ORIF) have not been studied. The objective of this study was to assess 10-year national trends in (1) patient characteristics and comorbidities and (2) 30-day postoperative adverse outcomes for patients who underwent distal radius fracture ORIF using a large patient database. Methods: A retrospective study was conducted using the National Surgical Quality Improvement Program database by querying the procedural codes for distal radius fracture ORIF from January 1, 2011, to December 31, 2020. A cohort of 28,616 adult patients who underwent distal radius fracture ORIF during the study period was included. Baseline patient characteristics and 30-day postoperative outcome data were collected for each year of the study. Temporal trends from 2011 to 2020 for all variables were assessed using the twotailed Mann-Kendall trend test. Results: Of the 28,616 patients in the study cohort, the mean age was 56.4 years and 73.1% were female. Demographically, there was a trend toward higher body mass index, higher American Society of Anesthesiologists classification, and lower proportions of active smokers; functionally dependent patients; and patients with hypertension, chronic obstructive pulmonary disease, and bleeding disorder. There was a trend toward worse sepsis physiology and wound classification on presentation. There was a trend toward fewer blood transfusions, hospital readmissions, and revision surgeries; however, there was an increasing trend for the development of a superficial surgical site infection. Discussion: Ten-year national trends in distal radius fracture ORIF demonstrated improvements in several important patient comorbidities and the rates of readmission and revision surgery.

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“…35 Other studies have evaluated more patient-specific risk factors including age, smoking status, BMI, and frailty to understand the importance of these factors affecting the complication rate. [33][34][35][36][37][38] Hand surgery is generally regarded as low risk; however, the involvement of trainees during these procedures is unknown. The findings from this study show that resident/fellow involvement is not a risk factor for complications.…”

Section: Discussionmentioning

confidence: 99%

“…The low short-term complication rate noted in the current study is similar to prior evaluations after ORIF for DRF. [33][34][35][36][37][38] Using the NSQIP database, Jiang et al reported a complication rate of 2% and reoperation rate of 1.1% after DRF fixation. 35 Other studies have evaluated more patient-specific risk factors including age, smoking status, BMI, and frailty to understand the importance of these factors affecting the complication rate.…”

Section: Discussionmentioning

confidence: 99%

“…32 The short-term complications after DRF open reduction internal fixation (ORIF) are reportedly low with a few known patient-specific risk factors. [33][34][35][36][37][38] We sought to use a national surgical database to answer our primary research questions: (1) does resident/fellow involvement increase short-term complication risk and surgical complications following ORIF for DRF and (2) does resident/fellow involvement have an opportunity cost with regard to the length of hospital stay? We hypothesized that major and minor adverse events and length of hospital stay would not significantly differ with the inclusion of a resident or fellow orthopaedic surgeon.…”

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confidence: 99%

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Resident and Fellow Participation Does Not Affect Short-Term Postoperative Complications After Distal Radius Fracture Fixation

et al. 2022

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Background Complications after open reduction internal fixation (ORIF) for distal radius fractures (DRF) are well documented, but the impact of trainee involvement on postoperative outcomes has not been studied. Questions Does trainee involvement affect postoperative complication rates and length of hospital stay? Methods The American College of Surgeons National Surgical Quality Improvement Program was queried from 2006 to 2012 for patients undergoing DRF ORIF. A 1:1 propensity score matched resident/fellow involved cases to attending-only cases. Demographics, length of stay, and postoperative complications were compared between the two groups. Logistic regression was used to evaluate independent predictors of adverse events and to evaluate cases with and without trainee involvement. Results Overall, 3,003 patients underwent DRF ORIF from 2006 to 2012. After matching, 1,150 cases (50% with resident/fellow involvement) were included. The overall rate of adverse events was 4.4% (46/1,050). There were no significant differences in the short-term complication rate in trainee-involved (2.3%) versus attending-only cases (3.9%) (p = 0.461). For ORIF of DRF, there were no significant differences, between attending-only cases and resident/fellow-involved cases, with regard to short-term major complications (p = 0.720) or minor complications (p = 0.374). Length of hospital stay was similar between cohorts (1.22 vs. 0.98 days) (p = 0.723). On multivariate analysis, trainee involvement was not an independent predictor of minor, major, or any complication after DRF fixation after controlling for multiple independent factors (all p > 0.364). Discussion Trainee participation in DRF ORIF is not associated with increased risk of short-term (30 days) medical or surgical postoperative complications. Level of Evidence This is a Level IV case–control study.

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Elevated BMI is associated with intra-articular comminution, prolonged operative time, and postoperative complications in distal radius fractures

Cited by 10 publications

References 32 publications

Analysis of Postoperative Complications and Related Factors Affecting Prognosis in 50 Patients with Distal Radius Fractures

Analysis of Postoperative Complications and Related Factors Affecting Prognosis in 50 Patients with Distal Radius Fractures

Ten-year National Trends in Patient Characteristics and 30-day Outcomes of Distal Radius Fracture Open Reduction and Internal Fixation

Resident and Fellow Participation Does Not Affect Short-Term Postoperative Complications After Distal Radius Fracture Fixation

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