Investigating Outcomes Following Distal Upper Extremity Fractures in Chronic Kidney Disease Patients

Chronic kidney disease (CKD) affects bone health and fracture healing, with limited research on distal upper extremity fractures. This study evaluated the impact of CKD on fracture outcomes, including healing time, complications, and mortality, to inform surgical management strategies.

A retrospective review was conducted on patients with CKD stages 1-4 and end-stage renal disease who underwent distal upper extremity fracture repair at a level 1 tertiary hospital. Data on demographics, CKD stage, comorbidities, surgical details, and complications were analyzed. Radiographic union time was assessed. A national database was used for external validation and analysis of postoperative risks, including propensity-matched controls.

The CKD cohort (n = 29) showed significantly delayed fracture healing compared with controls (68.4 ± 9.2 versus 50.6 ± 8.0 d; P < 0.0001). CKD patients experienced higher rates of postoperative complications, including edema (P = 0.0001) and weakness (P = 0.0001). TriNetX database analysis corroborated these findings and revealed elevated risks for revision surgery (P = 0.018). Superficial surgical site infections were more frequent in CKD patients but did not reach statistical significance (P = 0.086).

CKD adversely affects outcomes following distal upper extremity fracture repair, emphasizing the need for tailored perioperative management. These findings highlight the importance of early identification of CKD-related risks to optimize patient care and outcomes.