Infection Rate in Type I Open Distal Radius Fractures Surgically Treated >24 Hours Post-Injury: A Comparison Study

• Published in: Hand (New York, N.Y.) Vol. 19; no. 4; pp. 614 - 621
• Main Authors: Colello, Michael J., Long, Edward, Zimmerman, Parker, Tanner, Stephanie L., Faucher, Gregory
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2024
• Subjects: Adult; Aged; Debridement - statistics & numerical data; Female; Fracture Fixation, Internal - adverse effects; Fracture Fixation, Internal - methods; Fracture Fixation, Internal - statistics & numerical data; Fractures, Open - complications; Fractures, Open - surgery; Humans; Male; Middle Aged; Patient Readmission - statistics & numerical data; Radius Fractures - surgery; Reoperation - statistics & numerical data; Retrospective Studies; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Time Factors; Time-to-Treatment - statistics & numerical data; Wrist Fractures; distal radius; trauma; fracture/dislocation; infection; outcomes; diagnosis; research and health outcomes; open fractures
• ISSN: 1558-9447; 1558-9455; 1558-9455
• DOI: 10.1177/15589447221131849

Purpose: To determine how time to surgical debridement and fixation affects infection and complication rate in type I open distal radius fractures by comparing patients treated within 24 hours with those treated >24 hours post-injury. Methods: A retrospective review identified 62 patients who sustained a type I open distal radius fracture that was treated surgically. Patients were stratified into groups based on time to surgical intervention. An additional analysis was performed on patients with an isolated type I open distal radius fracture treated as an inpatient or outpatient. The primary outcome measure was infection rate. Secondary outcome measures were complications, reoperations, and readmissions. Results: Thirty-eight patients underwent surgery ≤24 hours post-injury at an average of 14 hours. Twenty-four patients underwent surgery >24 hours post-injury at an average of 72 hours. There were a total of 9 complications in 8 patients (14.5%). The overall infection rate was 1.6%, with only 1 deep infection occurring in the group treated ≤24 hours post-injury. There were 7 reoperations (11.3%) and 1 readmission (1.6%). No differences were found between groups in any outcome measure. In the 27 patients with an isolated fracture, there were no differences in any outcome measure when treated as an inpatient or outpatient. Conclusions: We suggest that type I open distal radius fractures could be safely treated surgically >24 hours post-injury without increased risk of infection.