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American Association for Hand Surgery

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No Increased Risk of Infection When Type I Open Distal Radius Fractures are Surgically Treated >24 Hours Post-injury: A Comparison Study
Michael J. Colello, MD, Edward Long, MD, Parker Zimmerman, BS, Stephanie L. Tanner, MS and Gregory Faucher, MD, Prisma Health- Upstate, Greenville, SC

Introduction
The purpose of this study is to determine how the time to surgical debridement and fixation affects infection and complication rate in type I open distal radius fractures by comparing patients treated within 24 hours to those treated >24 hours post-injury.
Material & Methods
A retrospective review identified a cohort of patients who sustained a type I open distal radius fracture treated surgically at a large tertiary hospital system from 2010-2020. Patients were stratified into groups based on time to surgical intervention and whether they were treated as an inpatient or outpatient. The primary outcome measure was infection rate. Secondary outcome measures were complications, reoperations and readmissions related to the open distal radius fracture.
Results
Sixty-two patients were included. Thirty-eight patients underwent surgery <24 hours post-injury at an average of 14 hours (range, 3-23). Seventeen patients underwent surgery from 24-72 hours post-injury at an average of 40 hours (range, 25-67). Seven patients underwent surgery >72 hours post-injury at an average of 152 hours (range, 95-242). There was a total of 9 complications in 8 patients (14.5%) with no difference between groups (p=1.0). The overall infection rate was 1.6%, with no difference between groups (p=1.0). One deep infection occurred in the group treated <24 hours post-injury and no infections in the other groups. No difference was found between groups in reoperation or readmission rate. When data was stratified by whether patients were treated with an inpatient (49 patients) or outpatient (13 patients) surgical procedure, there were no differences between the groups in any outcome measure.
Conclusions
In conclusion, this study suggests that type I open distal radius fractures can safely be treated surgically as an outpatient >24 hours post-injury, even up to within 1 week, without increased risk of infection.


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