Renal impairment and time to fracture healing following surgical fixation of distal radius fracture

• Published in: European journal of orthopaedic surgery & traumatology Vol. 33; no. 4; pp. 1329 - 1334
• Main Authors: Lai, Sean Han Sheng, Tang, Camelia Qian Ying, Chiow, Si Min, Chia, Dawn Sinn Yii
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.05.2023; Springer Nature B.V
• Subjects: Bone Plates; Fracture Fixation; Fracture Fixation, Internal; Fracture Healing; Fractures; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Radius Fractures - surgery; Surgical Orthopedics; Traumatic Surgery; Wrist Fractures; Perioperative assessment; Chronic kidney disease; Renal impairment; Distal radius fracture; Osteopenia
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-022-03300-4

Introduction Despite the prevalence of renal impairments, the existing literature examining fracture healing in the upper limb in patients with renal impairment is sparse. This study hence aims to investigate the effect of renal impairment on time to fracture healing after distal radius fracture fixation surgery. Materials and methods Patients above 50 years old who underwent distal radius fracture fixation via volar plating were included. Time to fracture healing was defined as duration between day of surgery and presence of radiographic union as evidence by bridging of callus or osseous bone. To assess for renal impairment, estimated glomerular filtration rate (eGFR) was calculated based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Pre-existing comorbidities were also collected and analysed. Results Ninety-nine consecutive patients took mean 65.5 ± 8.0 days to fracture healing post-operatively. Patients with renal impairment had longer time to fracture healing than patients without (67.1 ± 50.4 days versus 50.4 ± 31.8 days, p  = 0.044). Patients ≥ 65 years also had a longer duration to fracture healing compared to patients < 65 years (mean 63.7 ± 53.0 days versus 50.2 ± 27.2 days, p  = 0.033). Similarly, patients with ASA Class I had a shorter mean time to fracture healing than patients with ASA Class II and above (mean 42.5 ± 22.8 days versus 62.8 ± 47.6 days, p  = 0.028). Conclusions Time to fracture healing post-distal radius fracture fixation was significantly related to renal impairment, age and ASA classification.