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Fixation type, time to debridement have no impact on infection rate for grade I, II open distal radius fractures
Kurylo JC, et al. J Hand Surg. 2011. doi:10.1016/j.jhsa.2011.04.014
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Time to debridement and type of fracture fixation do not appear to have an impact on infection rate for grade I and II open distal radius fractures, according to researchers in Boston.
The authors cautioned, however, that while plating at the initial debridement might be safe, there are questions as to the relative safety of temporary external fixation followed by a staged conversion to plating, as they have noted an increased risk of complications and the potential for further corrective secondary procedures.
The researchers examined the information of 32 open distal radius fracture patients in a database. Ten debridements were treated within 6 hours of hospital admission, and 22 were delayed longer than 6 hours. Twenty fractures were treated with external fixation, 7 with plating and 5 with planned staged conversion from external fixation to plating, with the attending surgeon’s experience and preference serving as the deciding factor.
Time to debridement or use of immediate plating appeared to have no impact on infection rates, the study found, as there were no infections. Complications that necessitated secondary procedures were more likely in patients who underwent planned staged conversion.