Timing of Treatment of Open Fractures of the Distal Radius in Patients Younger Than 65 Years.

Abstract

The authors aimed to characterize surgical and functional outcomes of open fractures of the distal radius in patients younger than 65 years. At their level I trauma center, the authors conducted a retrospective review of 92 patients (age range, 16-64 years) who had 94 open fractures of the distal radius (average follow-up, 30 months; range, 3-95 months). Sixty-four fractures received definitive treatment at the time of initial débridement; 30 received definitive fixation and soft tissue coverage after staged débridement. Primary surgical outcome was development of deep surgical site infection requiring repeat surgical débridement; secondary surgical outcome was surgical complications requiring reoperation. Functional outcome was assessed by wrist range of motion. Overall infection rate was 15% (14 of 94 fractures). Seven (11%) of 64 fractures in the immediate definitive fixation group developed infection compared with 7 (23%) of 30 fractures in the staged treatment group (P=.13). Twenty-one (33%) of 64 fractures in the immediate definitive fixation group required reoperation compared with 15 (50%) of 30 in the staged treatment group (P=.11). Deep surgical site infections and surgical complications associated with open fractures of the distal radius are driven by soft tissue injury. [Orthopedics. 2019; 42(4):219-225.].