Investigating Outcomes Following Distal Upper Extremity Fractures in Chronic Kidney Disease Patients.

IF 1.8 Q3 SURGERY

Plastic and Reconstructive Surgery Global Open Pub Date : 2025-09-26 eCollection Date: 2025-09-01 DOI:10.1097/GOX.0000000000007105

Daniel Villarreal Acha, Zuhair Zaidi, Muhammad H Harirah, Berkay Basagaoglu, Muaz Wahid, Amber McCranie, Michael E Nissan, Richard Samade, Jennifer Kargel

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Abstract

Background: Chronic kidney disease (CKD) affects bone health and fracture healing, with limited research on distal upper extremity fractures. This study evaluated the impact of CKD on fracture outcomes, including healing time, complications, and mortality, to inform surgical management strategies.

Methods: A retrospective review was conducted on patients with CKD stages 1-4 and end-stage renal disease who underwent distal upper extremity fracture repair at a level 1 tertiary hospital. Data on demographics, CKD stage, comorbidities, surgical details, and complications were analyzed. Radiographic union time was assessed. A national database was used for external validation and analysis of postoperative risks, including propensity-matched controls.

Results: The CKD cohort (n = 29) showed significantly delayed fracture healing compared with controls (68.4 ± 9.2 versus 50.6 ± 8.0 d; P < 0.0001). CKD patients experienced higher rates of postoperative complications, including edema (P = 0.0001) and weakness (P = 0.0001). TriNetX database analysis corroborated these findings and revealed elevated risks for revision surgery (P = 0.018). Superficial surgical site infections were more frequent in CKD patients but did not reach statistical significance (P = 0.086).

Conclusions: CKD adversely affects outcomes following distal upper extremity fracture repair, emphasizing the need for tailored perioperative management. These findings highlight the importance of early identification of CKD-related risks to optimize patient care and outcomes.

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慢性肾病患者上肢远端骨折后的预后研究。

背景：慢性肾脏疾病（CKD）影响骨骼健康和骨折愈合，对上肢远端骨折的研究有限。本研究评估了CKD对骨折结果的影响，包括愈合时间、并发症和死亡率，为外科治疗策略提供信息。方法：回顾性分析在某三级甲等医院行上肢远端骨折修复术的1-4期CKD终末期肾病患者。统计数据、CKD分期、合并症、手术细节和并发症进行分析。评估影像学愈合时间。使用国家数据库进行外部验证和术后风险分析，包括倾向匹配对照。结果：CKD队列（n = 29）与对照组相比，骨折愈合明显延迟（68.4±9.2 d vs 50.6±8.0 d; P < 0.0001）。CKD患者的术后并发症发生率较高，包括水肿（P = 0.0001）和虚弱（P = 0.0001）。TriNetX数据库分析证实了这些发现，并显示翻修手术的风险增加（P = 0.018）。CKD患者手术部位浅表感染发生率较高，但差异无统计学意义（P = 0.086）。结论：CKD对上肢远端骨折修复后的预后有不利影响，强调需要量身定制围手术期管理。这些发现强调了早期识别ckd相关风险对优化患者护理和结果的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Plastic and Reconstructive Surgery Global Open SURGERY-

CiteScore

2.20

自引率

13.30%

发文量

1584

审稿时长

10 weeks

期刊介绍： Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.