Morrison Kerry A, Rocks Madeline C, Comunale Victoria, Desai Karan, Nicholas Rebecca S, Azad Ali, Ayalon Omri, Hacquebord Jacques H
NYU Langone Health, New York, USA.
Hand (N Y). 2024 Jun 10:15589447241257644. doi: 10.1177/15589447241257644.
This study investigates whether open distal radius fractures (ODRFs) treated after 24 hours from time of injury have an increased risk of infection or overall complication profile compared with those treated within 24 hours.
Retrospective review was performed of all patients treated for ODRF over a 6-year period at a single large academic institution. Postoperative complications included surgical site infections, need for revision irrigation and debridement, delayed soft tissue healing, loss of reduction, nonunion, and malunion.
One-hundred twenty patients were treated for ODRF. Mean (SD) age at time of injury was 59.92 (17.68) years. Twenty patients (16.7%) had postoperative complications. Regarding mechanism of injury, 78 (65.0%) had a low-energy and 42 (35.0%) had a high-energy injury. Age and fracture grade were not significant factors. Mean (SD) open wound size was 1.18 (1.57) cm. Mean (SD) time from injury presentation to the emergency department (ED) and first dose of intravenous antibiotics was 3.07 (4.05) hours and mean (SD) time from presentation to the ED and operative treatment was 11.90 (6.59) hours, which did not show a significant association with postoperative complications. Twenty-four patients (20.0%) were treated greater than 24 hours after presentation to the ED, which was not significantly distinct from those treated within 24 hours.
Patients with ODRFs treated after 24 hours were not associated with a greater risk of postoperative complications. Factors including age, energy and mechanism of injury, and fracture grade did not alter outcome in any statistically significant manner.
Level IV.
本研究旨在调查与伤后24小时内接受治疗的开放性桡骨远端骨折（ODRF）相比，伤后24小时后接受治疗的患者是否有更高的感染风险或总体并发症情况。
对一家大型学术机构6年内接受ODRF治疗的所有患者进行回顾性研究。术后并发症包括手术部位感染、需进行翻修冲洗和清创、软组织愈合延迟、复位丢失、骨不连和畸形愈合。
120例患者接受了ODRF治疗。受伤时的平均（标准差）年龄为59.92（17.68）岁。20例患者（16.7%）出现术后并发症。关于损伤机制，78例（65.0%）为低能量损伤，42例（35.0%）为高能量损伤。年龄和骨折分级不是显著因素。开放性伤口的平均（标准差）大小为1.18（1.57）厘米。从受伤到急诊科（ED）就诊以及首次静脉注射抗生素的平均（标准差）时间为3.07（4.05）小时，从到ED就诊到手术治疗的平均（标准差）时间为11.90（6.59）小时，这与术后并发症无显著关联。24例患者（20.0%）在到ED就诊后24小时以上接受治疗，这与24小时内接受治疗的患者无显著差异。
伤后24小时后接受治疗的ODRF患者术后并发症风险并未增加。年龄、损伤能量和机制以及骨折分级等因素均未以任何具有统计学意义的方式改变结果。
四级。
