Estrogen Replacement Therapy and Postoperative Complications After Distal Radius Open Reduction and Internal Fixation

Area of Science:

• Orthopedic surgery
• Pharmacology
• Patient outcomes

Background:

• Limited research exists on postoperative outcomes for patients on estrogen replacement therapy (ERT) undergoing distal radius open reduction and internal fixation (DR-ORIF).
• Understanding potential complications is crucial for patient management and surgical planning.

Purpose of the Study:

• To compare surgical and medical complications in patients on ERT undergoing DR-ORIF versus a matched control group.
• To identify any associations between preoperative ERT and adverse postoperative outcomes.

Main Methods:

• A retrospective cohort study using the PearlDiver Mariner database.
• Propensity score matching was used to create a 1:4 ratio of ERT users to non-ERT controls.
• Complications were assessed at 90 days, 2 years, and 5 years post-DR-ORIF.

Main Results:

• The ERT cohort (1,815 patients) showed a slightly increased incidence of malunion/nonunion at 2 years (OR, 1.57) and 5 years (OR, 1.69).
• No increased risk of revision surgery was observed in the ERT cohort at 2 years (OR, 1.10).
• No other significant major or minor complications were associated with preoperative ERT use within 5 years.

Conclusions:

• Preoperative ERT is associated with a slightly elevated risk of malunion/nonunion after DR-ORIF.
• No significant increase in other major or minor complications was found for ERT users within five years postoperatively.
• Further research may explore specific ERT formulations or patient factors influencing these outcomes.