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

Abstract

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. Patients above 50years 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. Ninety-nine consecutive patients took mean 65.5 ± 8.0days to fracture healing post-operatively. Patients with renal impairment had longer time to fracture healing than patients without (67.1 ± 50.4days versus 50.4 ± 31.8days, p = 0.044). Patients ≥ 65years also had a longer duration to fracture healing compared to patients < 65years (mean 63.7 ± 53.0days versus 50.2 ± 27.2days, 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 ± 22.8days versus 62.8 ± 47.6days, p = 0.028). Time to fracture healing post-distal radius fracture fixation was significantly related to renal impairment, age and ASA classification.