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Time to surgery and outcomes following open reduction and internal fixation of both-bone forearm fractures

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To determine the effect of time to surgery on outcomes following open reduction and internal fixation (ORIF) of both-bone forearm fractures (BBFFs).

Methods

Ninety-nine patients who underwent ORIF of BBFFs in a single academic medical center over a 16-year time period were retrospectively reviewed. Demographic and clinical data including age, sex, current smoking status, time from injury to surgery (tsurg), presence of open injury, polytrauma status, and complications were obtained. Radiographs of the affected extremity were reviewed for fracture morphology, reduction quality, and time to union (or presence of nonunion). In addition to descriptive statistics, Chi-square and Wilcoxon–Mann–Whitney tests were used to compare categorical and interval, respectively, with a significance level of 0.05.

Results

A tsurg > 48 h was associated with increased rate of delayed unions (tsurg < 48 h: 25% vs tsurg > 48 h: 59%, p = 0.03), but not complications (tsurg < 48 h: 44% vs tsurg > 48 h: 47%, p = 0.79). Open BBFFs were not associated with increased rates of delayed unions (closed: 16% vs open: 19%, p = 0.77) or complications (closed: 42% vs open: 53%, p = 0.29). A trend toward increased time to union with tsurg > 48 h was also seen, but did not reach significance (tsurg < 48 h: 13.5 weeks vs tsurg > 48 h: 15.7 weeks, p = 0.11).

Conclusion

A tsurg > 48 h is associated with an increased rate of delayed union, but not complications, after ORIF of BBFFs.

Level of evidence

Therapeutic Level III (Retrospective Cohort).

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Authors and Affiliations

  1. College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA

    Andrew Rust, Andrew B. Campbell & Timothy McManus

  2. Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY, 10021, USA

    Richard Samade

  3. Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX, 75390, USA

    Richard Samade

  4. Departments of Orthopaedics and Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH, 43212, USA

    Sonu A. Jain

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  1. Andrew Rust
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  2. Richard Samade
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Correspondence to Sonu A. Jain.

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Rust, A., Samade, R., Campbell, A.B. et al. Time to surgery and outcomes following open reduction and internal fixation of both-bone forearm fractures. Eur J Orthop Surg Traumatol 34, 135–142 (2024). https://doi.org/10.1007/s00590-023-03560-8

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  • DOI: https://doi.org/10.1007/s00590-023-03560-8

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