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Antidepressant Use and Risk of Reoperation After Distal Radius Open Reduction and Internal Fixation: A Propensity
Firdavs Kurbanov1, Christopher Dussik2, Amy Phan2
1University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY.
Journal of Hand Surgery Global Online
|February 2, 2026
Summary
Antidepressant use, including selective serotonin reuptake inhibitors (SSRIs) and other serotonergic agents, was linked to an increased risk of reoperation after distal radius fracture fixation. This finding suggests a potential impact on fracture healing and surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Bone Healing
Background:
- Antidepressant use is prevalent and may affect bone remodeling.
- The impact of antidepressants on fracture healing after surgical fixation is not well understood.
Purpose of the Study:
- To investigate the association between selective serotonin reuptake inhibitors (SSRIs) and non-SSRI serotonergic antidepressants and unplanned return to the operating room (RTOR) after open reduction and internal fixation (ORIF) of distal radius fractures.
Main Methods:
- Retrospective, propensity score-matched cohort study using TriNetX deidentified electronic health record data.
- Compared SSRI users and non-SSRI serotonergic users with nonusers for unplanned RTOR within 30-365 days post-ORIF.
- Analyzed risk differences, risk ratios, and hazard ratios.
Main Results:
- SSRI use was associated with a higher rate of unplanned RTOR (1.8% vs. 0.8%) compared to nonusers.
- Non-SSRI serotonergic antidepressant use also showed an increased risk of unplanned RTOR (2.4% vs. 0.6%) versus nonusers.
- Findings were consistent across absolute risk and time-to-event analyses.
Conclusions:
- Preoperative exposure to SSRIs or non-SSRI serotonergic agents is associated with a small but clinically significant increase in unplanned reoperation after distal radius ORIF.
- This suggests a potential negative impact of these antidepressants on fracture healing or surgical site complications.
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