Purpose
A paucity of evidence exists regarding the optimal treatment of open fractures of
the distal radius. The purpose of this study was to compare short-term complication
rates between various treatment options following open fractures of the distal radius.
Methods
We performed a retrospective review of all open fractures of the distal radius at
a single level 1 trauma center over a 10-year period. The primary outcome measure
was the number of minor and major complications. Demographic and clinical characteristics
of patients across treatment and outcome groups were compared and models were used
to describe the relationships between outcome and treatment.
Results
Ninety patients met the inclusion criteria for evaluation. An even distribution between
high-energy (n = 45) and low-energy (n = 45) injuries was seen with 61 fractures Gustilo
I (67%), 19 Gustilo II (22%), and 10 Gustilo III (11%). The majority of fractures
were intra-articular (n = 48 AO type C vs n = 42 AO type A/B). Fractures were treated
with immediate open reduction internal fixation (ORIF) in 67 cases (74%), external
fixation in 12 (13%), initial external fixation followed by ORIF at a later time in
8 (9%), or closed reduction and percutaneous pinning in 3 (4%). We observed 33 complications
(37%) of which 24 were major and 9 minor. Mechanism of injury and type of treatment
were the only variables shown to correlate with an increased rate of complications.
Conclusions
We conclude that open fractures of the distal radius treated by immediate ORIF at
the time of index debridement can result in satisfactory outcomes compared with other
forms of treatment.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: October 12, 2019
Accepted:
August 13,
2019
Received:
August 9,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
