Risk Factors for Complications following Volar Locking Plate (VLP) Fixation of Unstable Distal Radius Fracture (DRF). (29th November 2022)

• Record Type: Journal Article
• Authors: Zhu, Yanbin; Liu, Song; Li, Yansen; Yang, Qianru; Miao, Ruoxiang; Zhang, Yingze
• Other Names: Zou Jun Academic Editor.
• Is Part Of: BioMed research international. Volume 2022(2022)
• Publication Date: 2022-11-29
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2022/9117533
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Objective . To evaluate the incidence and risk factors for complications following volar locking plate (VLP) fixation of unstable distal radius fracture (DRF). Methods . This retrospective study identified patients who underwent VLP fixation of unstable DRF between 2017 and 2020 with a minimum 12-month follow-up assessments. By reviewing electronic medical records and follow-up notes, patients were categorized complication or noncomplication group. Differences in variables were detected by using univariate analyses, and independent factors were identified using multivariate logistic regression analysis. Results . During this study period, 423 patients were included, and 63 (rate, 14.9%) complications in 58 patients were documented. Wound infection (17, 4.0%) was most common, followed in decreasing frequency by carpal tunnel syndrome (13, 3.1%), tendon rupture/irritation (10, 2.4%), complex regional pain syndrome (8, 1.9%), and plate/screw-related complications (5, 1.7%). In the univariate analyses, 18 variables were found to be significantly different (p < 0.05 ). Logistic regression analysis identified 5 independent factors, including being male (OR, 3.5; p = 0.014 ), type C fracture (vs. type A, OR: 2.7, and p = 0.035 ), general anesthesia (vs. regional, OR: 2.4, and p = 0.045 ), bone grafting (OR, 6.3; p < 0.001 ), and surgery performed by less experienced surgeons (OR, 3.1; p = 0.003 ). The goodness-of-fit of the final model was acceptable. Conclusions . These factors will help surgeons individualize and stratify the risk of complications and help patients for risk counselling; especially, an informed clinical decision targeting those modifiable factors (anesthesia mode, bone grafting, and surgeon experience) can be considered, when indicated.