Cerebral Palsy and Postoperative Outcomes After Distal Radius Fracture Repair: A Retrospective Analysis.

PURPOSE: To identify if patients with cerebral palsy (CP) are at increased risk of postoperative complications and repeat surgery following open reduction and internal fixation (ORIF) for distal radius fractures both acutely and in the long-term following their surgery.

METHODS

Using the Mariner 161 PearlDiver dataset, adult patients undergoing ORIF following a DRF were identified. Patients with CP were then matched 1:4 with a non-CP cohort based on age, sex, and the Elixhauser Comorbidity Index (ECI). The incidence of 90-day postoperative adverse events and readmissions were determined and compared using univariate and multivariate analyses. The 5-year repeat surgery rate of each cohort was compared using log-rank testing.

RESULTS

Prior to matching, there were 300,071 patients who underwent ORIF for distal radius fractures identified, of which 654 (0.2%) had CP. On multivariate analysis, the CP cohort had increase odds of all aggregated event groups: any adverse event (OR 4.06, 95% confidence interval [CI] 3.25-5.08), severe adverse event (OR 2.93, 95% CI 2.11-4.05), and minor adverse event (OR 4.32, 95% CI 3.41-5.48). Additionally, the CP cohort had increased odds of the following individual adverse events (in descending order): urinary tract infection (OR 5.32, 95% CI 4.01-7.06), myocardial infarction (OR 5.29, 95% CI 2.37-12.08), pneumonia (OR 4.15, 95% CI 2.83-6.07), sepsis (OR 4.08, 95% CI 2.41-6.90), pulmonary embolism (OR 3.73, 95% CI 1.60-8.58), transfusion (OR 3.71, 95% CI 1.59-8.57), acute kidney injury (OR 3.20, 95% CI 2.08-4.93), and deep vein thrombosis (OR 3.18, 95% CI 1.78-5.67).There was no difference in reoperation rate between the CP and non-CP cohort (2.3% vs 2.8%, P = 0.60).

CONCLUSIONS

Patients with CP who underwent ORIF were at increase odds of postoperative adverse events immediately following surgery bur had no difference in reoperation rate over 5 years.

TYPE OF STUDY/LEVEL OF EVIDENCE: Retrospective cohort study III.