Abstract
ObjectiveTo investigate the incidence of postoperative overall complications or secondary procedures following distal radius fractures treated by volar locking plate (VLP)MethodsElectronic medical records (EMR) of 1152 patients with 1175 distal radius fractures treated by volar locking plate between January 2013 and September 2018 were retrospectively reviewed and the data were extracted. The picture archiving and communication system (PACS) was inquired to assess the fracture severity and to determine the fracture type. Univariate and multivariate logistic regression analyses were used to identify the associated risk factors.ResultsDuring the median follow-up period of 6 months, a total of 138 complications in 131 patients were determined, indicating the accumulated rate of 11.7%; there were 68 cases of secondary procedures, with the rate of 5.8%. The independent associated factors for postoperative overall complications were AO type C fracture (OR, 2.6; 95%CI, 1.2 to 4.0), open fracture (OR, 4.2; 95%CI, 1.9 to 6.5), and significant collapse of the lunate fossa (OR, 2.9; 95%CI, 13 to 4.3), and for secondary procedures were significant collapse of the lunate fossa (OR, 3.7; 95%CI, 1.7 to 6.4) and the low-volume of surgeons (OR, 95%CI, 1.2 to 3.6)ConclusionsIdentification of these factors is of importance for the risk assessment of postoperative complications and the additional need of surgery. For patients with the above factors, especially those with combined risk factors, optimized operation scheme and high-volume surgeon should be considered to prevent or reduce the complications.
Highlights
Distal radius fracture is the most common injury in department of emergency, trauma, or hand surgery
Exclusion criteria were (1) old fractures (> 3 weeks since fracture occurrence) or pathological fracture, (2) treatments other than volar locking plate (VLP), (4) patients who referred to another hospital for treatment of complications, and (5) patients who were lost to follow-up due to contact information change or due to personal affairs
From January 2013 to September 2018, a total of 1962 patients with distal radius fractures were treated surgically in our hospital, and 1378 of whom were treated with VLP fixation (1406 distal radius fractures)
Summary
The incidence of complications directly related to the plate was between 4% and 36% [9,10,11], Li et al Journal of Orthopaedic Surgery and Research (2019) 14:295 and the secondary revision surgery rate was between 2% and 34% [12,13,14]. These complications affect the surgical results, but often require secondary operations, which prolong the hospital stay and increase the total costs of treatment [15, 16]
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