Predicting the Presence of Compressive Conditions After Distal Radius Fractures.

INTRODUCTION

Distal radius fractures are among the most common orthopedic injuries. Despite adequate fracture management, some patients experience delayed onset of compressive conditions, increasing the overall treatment burden. Identifying risk factors for these complications is important to improve patient outcomes. We sought to identify independent preoperative factors associated with the delayed development of compressive conditions following distal radius fracture management.

METHODS

A retrospective review was conducted of patients with distal radius fractures over a decade. Data collected included demographic information, fracture characteristics, treatment modality (operative vs. nonoperative), and the subsequent incidence of compressive pathologies for 1 year after injury. Multivariate regression was performed to isolate the most predictive factors.

RESULTS

Of 462 patients, 15.4% developed a compressive condition, with carpal tunnel syndrome being the most common (11%). Significant predictors for delayed development of compressive condition were diabetes (odds ratio [OR], 3.34) and increasing age (OR, 1.02). Complex fractures and operative treatment of fractures predicted treatment for a compressive condition, whereas increasing age was the only factor associated with requiring a secondary surgery (OR, 0.92). Preoperative diagnoses were not found to be a significant risk factor.

CONCLUSION

Diabetes and increasing age were the primary predictors for development of delayed onset of compressive neuropathy or tendinopathy following distal radius fracture treatment, with age being the only factor associated with increased need for surgical intervention. Although operative treatment of distal radius fracture was not correlated with development of delayed compressive conditions, it was associated with an increased need for subsequent interventions.

LEVEL OF EVIDENCE: III.