Postsurgical Complications following Distal Radius Volar Plating in a Diabetic Population at Short-Term Follow-up

• Published in: Hand (New York, N.Y.) Vol. 10; no. 4; pp. 670 - 677
• Main Authors: Koehler, Daniel M., Gao, Yubo, Guan, Justin J., Lawler, Ericka A., Adams, Brian D., Shah, Apurva S.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.12.2015; Springer US
• Subjects: Medicine; Medicine & Public Health; Orthopedics; Plastic Surgery; Surgery; Surgical Orthopedics; Volar locked plating; Diabetes mellitus; Distal radius fracture
• ISSN: 1558-9447; 1558-9455
• DOI: 10.1007/s11552-015-9777-4

Background Diabetes mellitus increases the risk of complications following operative treatment of lower extremity fractures. There is little published data establishing the impact of diabetes following surgical treatment of upper extremity fractures. This investigation aimed to compare the incidence of short-term postsurgical complications following volar locked plating of distal radius fractures in patients with and without diabetes. Methods A retrospective matched cohort investigation of 33 diabetics matched 1:2 to 66 non-diabetics was performed, accounting for age, gender, fracture type, and smoking status. Electronic medical records and radiographs were reviewed for all major and minor postsurgical complications. Demographic characteristics, postoperative radiographic parameters, and final range of motion were also compared. Mean follow-up was 5.3±8.2 and 5.5±7.8 months for diabetics and non-diabetics, respectively. Results The diabetic cohort had a significantly higher overall complication rate with 24 postsurgical complications affecting 12 patients (36 %) compared to 16 complications affecting 12 patients (18 %) in the non-diabetic cohort. There was no difference in the incidence of major complications requiring operative intervention. Minor complications were significantly more common in the diabetic group and were largely accounted for by peripheral neuritis with an incidence of 30 %. Final radiographic outcomes and range of motion were similar. Conclusions Diabetics experienced a greater incidence of minor postsurgical complications following volar locked plating of distal radius fractures when compared to a matched, control population. The difference in outcomes is largely accounted for by the increased incidence of peripheral neuritis among diabetics. Diabetic patients should be counseled preoperatively regarding their elevated risk profile.