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. 2024 Mar 22:11:1356121.
doi: 10.3389/fsurg.2024.1356121. eCollection 2024.

Factors predicting complications following open reduction and internal fixation of intra-articular distal radius fracture

Lingde Kong #  1 , Hua Li #  2 , Yanqing Zhou  2 , Bing Zhang  1 , Quan Han  3 , Meng Fu  4
Affiliations

Factors predicting complications following open reduction and internal fixation of intra-articular distal radius fracture

Lingde Kong et al. Front Surg. .

Abstract

Objective: This study aimed to determine the incidence and predictors of the complications after open reduction and internal fixation (ORIF) of intra-articular distal radius fracture (IADRF) with a minimum follow-up of 12 months.

Methods: Medical records and outpatient follow-up records were retrospectively reviewed to collect medical, surgical, and complication data on consecutive patients who had undergone an ORIF procedure for an IADRF between January 2019 and June 2022. Data included demographics, comorbidities, injury, surgical characteristics, and laboratory findings on admission. A multivariate logistic regression model was constructed to identify the significant predictors, with a composite of any complications occurring within 12 months after the operation as the outcome variable and potentially a range of clinical data as the independent variables. The magnitude of the relationship was indicated by the odds ratio (OR) and the 95% confidence interval (CI).

Results: During the study period, 474 patients were included, and 64 had documented complications (n = 73), representing an accumulated rate of 13.5%. Among them, carpal tunnel syndrome was the most common, followed by tenosynovitis caused by tendon irritation/rupture, superficial or deep wound infection, complex regional pain syndrome (CRPS) type 1, radial shortening (≥4 mm), plate/screw problems, and others. The multivariate results showed the following factors significantly associated with increased risk of complications: experience of DRF surgery with <30 cases (OR: 2.2, 95% CI: 1.6-3.5), AO type C fracture (OR: 1.7, 95% CI: 1.2-2.9), initial lunate facet collapse of ≥5 mm (OR: 4.2, 95% CI: 1.4-8.9), and use of temporary external fixation before index surgery (OR: 2.4, 95% CI: 1.5-4.3).

Conclusions: These findings may aid in patient counseling and quality improvement initiatives, and IADRF should be directed by an experienced surgeon.

Keywords: complication; intra-articular distal radius fracture; patient counseling; predictors; risk assessment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing the patient inclusion in the study.
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