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· DOS Abstracts
Identifying a possible change in the complication
rate when treating dislocated distal radius
fractures over a period of 6 years by open
reduction and internal fixation using volar plating
Roland Knudsen, Frank Damborg, Julie Ladeby Erichsen, Zafar Bahadirov
Department of Orthopedic Surgery, Odense University Hospital; Department
of Orthopedic Surgery, Kolding Hospital; Department of Orthopedic Surgery,
Kolding Hospital; Department of Orthopedic Surgery, Kolding Hospital
Background:
Recent studies have shown a complication rate between 8-27%
when treating Dislocated Distal Radius Fractures (DDRF) using Open Reduction
and Internal Fixation (ORIF) and a volar plate. This kind of osteosynthesis is a
relatively new treatment and initiatives must be identified and implemented to
reduce this rate of complications.
Purpose / Aim of Study:
We wanted to investigate whether the complication
rate changed over time between the period 2008 to 2010 and 2013 to July
2014 at a single institution.
Materials and Methods:
We compared two cohorts of patients, who had their
DDRF treated with volar plating at the same institution in the above-mentioned
periods. There were two differences between the two cohorts: in the latter
period more operations were supervised and the surgeons had gained more
experience in the latter period. The possible complications were: carpal tunnel
syndrome, tendon irritation/rupture, insufficient osteosynthesis, reduced ROM,
infection, complex regional pain syndrome and skin healing problems. The com-
plications were only registered as a complication if an intervention was deemed
necessary.
Findings / Results:
88% of the operations in the last group were performed or
supervised by a qualified orthopaedic surgeon versus 79% in the first group (p <
0,01). The overall complication rate was reduced from 18% to 13% (p<0,01).
The rate of two kinds of complications was reduced significantly: Tendon irrita-
tion/rupture was reduced from 5% to 1% (p=0,02) and insufficient osteosyn-
thesis rate was reduced from 7% to 2% (p<0,01).
Conclusions:
The overall complication rate was reduced significantly from 18
to 13%. We believe, the reduction of complications is mainly because of in-
creased supervision and because the qualified orthopaedic surgeons became
more familiar with this procedure.
No conflicts of interest reported
167.