Resident involvement in open reduction, internal fixation did not increase adverse events
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LAS VEGAS — Presented results showed resident involvement in open reduction and internal fixation for distal radius fractures was linked with longer operative time, but there was no difference in rates of episode-of-care adverse events.
“You can assure your patients that involving a resident [in open reduction and internal fixation for distal radius fractures] does not negatively impact their short-term outcomes,” George S. M. Dyer, MD, FAAOS, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Using the American College of Surgeons National Surgical Quality Improvement Program database, Dyer and colleagues collected demographics and comorbidities, intraoperative factors and 30-day postoperative outcomes among 5,693 patients who underwent open reduction and internal fixation for distal radius fracture. Researchers performed bivariate statistical analyses to identify variables associated with complication, readmission, reoperation and operative time.
Dyer noted 66 patients had a complication, 85 patients were readmitted and 61 patients underwent reoperation.
“Resident involvement in the surgery was not associated with any [of those results],” Dyer said. “It was associated with longer operative time.”
Results showed an association between 30-day postoperative complications with older patient age, American Society of Anesthesiologist (ASA) classification, chronic obstructive pulmonary disease (COPD), chronic heart failure, hypertension and bleeding disorder. Researchers also found older patient age, ASA classification, diabetes mellitus, COPD, hypertension, bleeding disorder and function status were associated with 30-day readmission, while 30-day reoperation was associated with higher BMI.
“In addition to resident involvement, longer operative time was associated with younger age, which makes sense, male sex and, interestingly, the absence of a bleeding disorder,” Dyer said.
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Earp BE, et al. Paper 344. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.
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