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Does Time to Operative Intervention of Distal Radius Fractures Influence Outcomes?
Xavier Simcock, MD1; Mithun Neral, MD2; Blaine Bafus, MD2; Harry Hoyen, MD3; Kevin Malone, MD4
1Cleveland Clinic Foundation, Cleveland, OH, 2Case Western Reserve University School of Medicine, Cleveland, OH, 3Metro Health Medical Center, Cleveland, OH, 4University Hospital Case Medical Center, Cleveland, OH
Abstract Background: No investigation has analyzed the time from injury to operative intervention and its effect on complications and functional outcomes in distal radius fractures. The goal of this investigation was to establish if time to surgical intervention from injury was associated with the observed rate of complications in distal radius fractures.
Methods: A retrospective review of all trauma patients who came to MetroHealth Medical Center and were entered into an orthopaedic trauma database was conducted from 2008 through 2014. Patients who sustained closed distal radius fractures were included. A post-operative complication following distal radius fracture was defined as reoperation, superficial or deep infection, complex regional pain syndrome, new onset carpal tunnel syndrome, tendon irritation and symptomatic hardware.
Results: 205 patients were included in the study with a mean age of 48 years old ( SD ±14.7). According to the AO/OTA classification radiographs revealed 80 A fractures, 15 B fractures, and 110 C fractures. 38 distal radius fixed within 0 to 3 days after the injury, 95 patients were operated on within 4 to 10 days, and 71 patients after 10 days. Overall 28 complications (13.7 %) were identified. There was no statistical difference in rate of complications between the time interval groups ( pval = 0.17 ).
Conclusion: Despite the increased popularity of surgical intervention for distal radius fractures the optimal parameters to maximize patient outcomes have yet to be clearly defined. Time to intervention did not affect the rate of post-operative complication and range of motion.
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