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Complications after distal radius fracture surgery: results from a Swedish nationwide registry study
Cecilia Mellstrand Navarro1, Hans J Pettersson, Anders Enocson
1*Orthopaedics Section, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden; and †Statistics Section, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Objectives:
To evaluate complications after distal radius fracture surgery.
Design:
Prospective registry study.
Setting:
Nationwide registry study.
Patients:
A total of 36,618 patients who underwent surgery because of a distal radius fracture during the period from January 1, 2001 to December 31, 2009 were followed from the date of operation until the occurrence of either reoperation, a new distal radius fracture, death, or December 31, 2010, whichever occurred first.
Main Outcome Measurement:
The occurrence of reoperations after different surgical methods is presented as proportions, incidence rates, and in a Kaplan-Meier survival analysis curve. Types and distributions of complications are presented for pinning, external fixation (EF), and plating, respectively.
Results:
The incidence of reoperation after fracture surgery using EF, pins, and plating was 100 [95% confidence interval (CI): 93-107], 140 (95% CI: 127-153), and 222 (95% CI: 207-237) per 10,000 person years, respectively. After stratified analysis adjusting for age and gender, the differences remained significant when comparing plating with EF (P = 0.001) and pinning (P = 0.01). Pinning and EF patients displayed an earlier onset of the complications when compared with plated patients.
Conclusions:
The incidence of reoperation was higher for patients treated with a plate than for patients treated with pins or EF. The timing of the reoperations differed in that pinning and EF patients displayed an earlier onset when compared with plated patients.
Level Of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
