The Effect of Hand Dominance, Age, Gender, Fracture Comminution and ASA Status on Time to Fracture Healing Following Surgical Fixation of Distal Radius Fractures

Abstract

Background: There is recent renewed interest in the effect of hand dominance on distal radius fractures. Current studies focus on functional or patient-reported outcomes, with lack of studies pertaining to radiological outcomes. The primary aim of this study is to examine the effect of hand dominance on time to fracture healing following surgical fixation of distal radius fracture. We also looked at the effect of age, gender, fracture comminution and American Society of Anaesthesiologists (ASA) status on time to fracture healing. Methods: Patients who underwent distal radius fracture fixation surgery in our department from 1 January 2015 to 31 December 2015 were included. Time to fracture healing was taken from the day of surgery to when radiographic union was present as evidence by bridging callus or osseous bone. We looked at the effect of hand dominance, age, gender, fracture comminution and ASA status on time to fracture healing. Results: One hundred and forty-five consecutive patients (80 females and 65 males) had a mean period of 56.2 ± 41.8 days to fracture healing post-operatively. Patients with dominant hand injury had a shorter duration to fracture healing than patients with non-dominant hand injury (mean 47.3 ± 31.1 days versus 62.1 ± 46.8 days, p = 0.023). Patients ≥ 65 years and with pre-existing medical conditions (ASA Class II and above) had a longer duration to fracture healing (mean 63.7 ± 53.0 days versus 51.9 ± 33.4 days, p = 0.036 and mean 47.9 ± 30.0 days versus 62.0 ± 47.7 days, p = 0.016, respectively). In addition, patients with comminuted fractures took longer to heal than patients with non-comminuted fractures (mean 57.6 ± 33.4 days versus 48.3 ± 20.8 days, p = 0.038). Conclusion: Time to fracture healing post distal radius fracture fixation surgery was significantly related to hand dominance, as well as age, ASA classification and fracture configuration. Dominant wrist injuries had shorter time to fracture healing. Level of Evidence: Level IV (Therapeutic)

Methods to accelerate fracture healing – a narrative review from a clinical perspective

“…Direct or indirect fracture healing may occur ( 1 ), also called contact healing when the bone ends are in direct contact and gap healing when they are not directly apposed. On average, the healing time (also known as the union time) is increased in smokers ( 135 ), in patients with osteoporosis ( 136 ), in patients receiving bisphosphonate therapy ( 137 ), in patients in a hypoxic environment, such as at high altitude ( 138 ), in patients with more complex fractures, including those associated with compartment syndrome ( 139 ), and in older patients and patients with several comorbidities ( 140 ).…”

Radiographic Analysis in Extra-Articular and Intra-Articular Distal Radius Fractures Treated with Variable-Angle Volar Locking Plate Fixation

“…We confirmed that all fractures had healed after three months, and there were no instance of infection or revision surgery. Previous research indicated that three months was sufficient for radiographic healing of distal radial fractures, which was evidenced by bridging callus or osseous bone [13]. All electronic medical records and diagnostic imaging studies were assessed by two of co-authors (Fang, PC and Chen, ACY) with a consensus regarding the assessment.…”