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American Association for Hand Surgery
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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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Is Time to Surgery Associated with Union or Infection Rate for Both Bone Forearm Fractures? A Single Institution 10-Year Retrospective Analysis
Andrew B Campbell, MD; Timothy McManus, BS; Sonu A. Jain, MD, FACS
The Ohio State University, Columbus, OH

Anatomic reduction and rigid fixation of diaphyseal radius and ulna shaft fractures is critical to maximizing functional outcome. The purpose of this study was to retrospectively characterize a series of patients that underwent open reduction internal fixation of a both bone forearm fracture. We also sought to determine whether timing of definitive surgical treatment is associated with a) fracture union, or b) infection after an open fracture. We hypothesized that increased time to surgery would not be associated with delayed union or post-operative infection in open fractures. A series of consecutive patients over a 10-year period at a single institution were retrospectively reviewed. Relevant demographic and outcomes data were systematically extracted. Radiographs were scrutinized to assess for bony union. A total of 139 consecutive patients were identified; after exclusions, 91 patients that underwent open reduction and internal fixation of diaphyseal radius and ulna fractures were included. There were 52 fractures that radiographically united (57%, average 13.5 5.5 weeks). Twenty-four fractures (26%) demonstrated progressive but incomplete radiographic healing at final follow-up. There were 15 cases of delayed union >6 months (16%), three of which required a revision open reduction internal fixation procedure (3%). All cases ultimately went on to union. There was no association between increased time to surgery and delayed union. Polytrauma status and bone loss were significant predictors of delayed union (p < 0.05). There was a trend toward a significant association between open fracture status and delayed union (p = 0.09), but there was no association between increased time to surgical debridement of an open fracture and post-operative infection.


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