Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates
Purpose: There is limited published evidence regarding the optimal management of type I open fractures of the distal radius. The purpose of this study was to compare short-term complication rates among open fractures of the distal radius, with attention to the timing of management of type I fracture...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Journal of Hand Surgery Global Online |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589514124001890 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832586260161495040 |
|---|---|
| author | Eric R. Taleghani, MD James Rex, MD Samuel Gerak, BA John Velasquez, MS Kathryn Rost, BS Sonu A. Jain, MD, FACS |
| author_facet | Eric R. Taleghani, MD James Rex, MD Samuel Gerak, BA John Velasquez, MS Kathryn Rost, BS Sonu A. Jain, MD, FACS |
| author_sort | Eric R. Taleghani, MD |
| collection | DOAJ |
| description | Purpose: There is limited published evidence regarding the optimal management of type I open fractures of the distal radius. The purpose of this study was to compare short-term complication rates among open fractures of the distal radius, with attention to the timing of management of type I fractures. Our hypothesis was that there would not be a temporal association between treatment and infection for type I open distal radius fractures (DRFs). Methods: A retrospective review of all open DRFs at a single level-1 trauma center over a 10-year period was performed. Patients were grouped based on Gustilo Anderson open fracture classification. The primary outcome measures were superficial and deep infection rates in all patients with a minimum of 6-month follow-up. A subgroup analysis was performed for Gustilo Anderson type I injuries with a 3-month follow-up based on time to surgery. Results: Seventy-one patients with open DRFs were included for analysis with an average follow-up of 16.7 months. There was a higher rate of deep infection (30%) and average number of revision surgeries (3.0) in the type III cohort compared with both type II (4% and 0.6) and type I (0% and 0.39) cohorts. A subgroup analysis of 63 type I fractures with a minimum of 3-month follow-up revealed zero infections, with no difference in other complications or number of revision surgeries among patients definitively managed within 24 hours, 24–72 hours, and greater than 72 hours. Two patients were managed nonoperatively, without complication. Conclusions: Type I open DRFs differ from higher grade DRFs with regard to demographics and injury characteristics, along with infection, complication, and reoperation rates. With no infections in the type I DRF cohort and no difference in complication rates based on time to debridement, our data suggest that it is safe to manage type I open DRFs similarly to closed injuries regarding surgical timing. Type of study/level of evidence: Therapeutic III. |
| format | Article |
| id | doaj-art-56fd9e5d102d4507b55342cae6ee9368 |
| institution | Kabale University |
| issn | 2589-5141 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Hand Surgery Global Online |
| spelling | doaj-art-56fd9e5d102d4507b55342cae6ee93682025-01-26T05:04:38ZengElsevierJournal of Hand Surgery Global Online2589-51412025-01-017115Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication RatesEric R. Taleghani, MD0James Rex, MD1Samuel Gerak, BA2John Velasquez, MS3Kathryn Rost, BS4Sonu A. Jain, MD, FACS5Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OHDepartment of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OHUniversity of Cincinnati College of Medicine, Cincinnati, OHUniversity of Cincinnati College of Medicine, Cincinnati, OHUniversity of Cincinnati College of Medicine, Cincinnati, OHDivision of Plastic and Reconstructive Surgery, University of Cincinnati, Cincinnati, OH; Corresponding author: Sonu A. Jain, MD, Division of Plastic and Reconstructive Surgery, University of Cincinnati, 231 Albert Sabin Way, ML 0581, Cincinnati, OH 45267-0581.Purpose: There is limited published evidence regarding the optimal management of type I open fractures of the distal radius. The purpose of this study was to compare short-term complication rates among open fractures of the distal radius, with attention to the timing of management of type I fractures. Our hypothesis was that there would not be a temporal association between treatment and infection for type I open distal radius fractures (DRFs). Methods: A retrospective review of all open DRFs at a single level-1 trauma center over a 10-year period was performed. Patients were grouped based on Gustilo Anderson open fracture classification. The primary outcome measures were superficial and deep infection rates in all patients with a minimum of 6-month follow-up. A subgroup analysis was performed for Gustilo Anderson type I injuries with a 3-month follow-up based on time to surgery. Results: Seventy-one patients with open DRFs were included for analysis with an average follow-up of 16.7 months. There was a higher rate of deep infection (30%) and average number of revision surgeries (3.0) in the type III cohort compared with both type II (4% and 0.6) and type I (0% and 0.39) cohorts. A subgroup analysis of 63 type I fractures with a minimum of 3-month follow-up revealed zero infections, with no difference in other complications or number of revision surgeries among patients definitively managed within 24 hours, 24–72 hours, and greater than 72 hours. Two patients were managed nonoperatively, without complication. Conclusions: Type I open DRFs differ from higher grade DRFs with regard to demographics and injury characteristics, along with infection, complication, and reoperation rates. With no infections in the type I DRF cohort and no difference in complication rates based on time to debridement, our data suggest that it is safe to manage type I open DRFs similarly to closed injuries regarding surgical timing. Type of study/level of evidence: Therapeutic III.http://www.sciencedirect.com/science/article/pii/S2589514124001890Distal radius fractureGustilo AndersonInfectionOpen fractureTrauma |
| spellingShingle | Eric R. Taleghani, MD James Rex, MD Samuel Gerak, BA John Velasquez, MS Kathryn Rost, BS Sonu A. Jain, MD, FACS Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates Journal of Hand Surgery Global Online Distal radius fracture Gustilo Anderson Infection Open fracture Trauma |
| title | Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates |
| title_full | Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates |
| title_fullStr | Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates |
| title_full_unstemmed | Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates |
| title_short | Timing of Type I Open Distal Radius Fracture Fixation Does Not Affect Early Complication Rates |
| title_sort | timing of type i open distal radius fracture fixation does not affect early complication rates |
| topic | Distal radius fracture Gustilo Anderson Infection Open fracture Trauma |
| url | http://www.sciencedirect.com/science/article/pii/S2589514124001890 |
| work_keys_str_mv | AT ericrtaleghanimd timingoftypeiopendistalradiusfracturefixationdoesnotaffectearlycomplicationrates AT jamesrexmd timingoftypeiopendistalradiusfracturefixationdoesnotaffectearlycomplicationrates AT samuelgerakba timingoftypeiopendistalradiusfracturefixationdoesnotaffectearlycomplicationrates AT johnvelasquezms timingoftypeiopendistalradiusfracturefixationdoesnotaffectearlycomplicationrates AT kathrynrostbs timingoftypeiopendistalradiusfracturefixationdoesnotaffectearlycomplicationrates AT sonuajainmdfacs timingoftypeiopendistalradiusfracturefixationdoesnotaffectearlycomplicationrates |