Risk Factors for Complications Following Open Reduction Internal Fixation of Distal Radius Fractures

Purpose A national surgical database was used to determine risk factors for complications in patients undergoing open reduction internal fixation (ORIF) for distal radius fractures. Methods The American College of Surgeons National Surgical Quality Improvement Program database for the 2006–2012 years was queried to identify all patients who underwent an ORIF of a distal radius fracture based on Current Procedural Terminology codes 25607, 25608, or 25609. The database is a statistically representative sample of prospectively collected perioperative surgical data from hospitals primarily in the United States. Demographics, comorbidities, preoperative laboratory values, and 30-day complications were compared between the patient groups with and without a postoperative complication. Multivariate analysis was performed to identify patient characteristics and comorbidities that were independently associated with early postoperative complications. Results This retrospective analysis identified 3,003 patients who underwent an ORIF of the distal radius over 7 years. The number of patients with a complication within 30 days after surgery was 62 (2%), totaling 90 complications. Incidence of return to the operative room for the entire study population was 1.1%. Multivariate analysis, adjusting for confounding variables, showed that patients with a complication were more likely to have hypertension, congestive heart failure, preoperative chemotherapy or radiotherapy, longer operating time, and manifest preoperative impairment in independent living. Conclusions Approximately 2% of patients sustained a complication within 30 days following ORIF of a distal radius fracture. Recognition of the risk factors may help avoid complications in the identified high-risk patients. Type of study/level of evidence Prognostic II.