The Effect of Mental Illness on Reoperation Rates and Follow-Up after Surgical Fixation of Distal Radius Fractures.

Abstract

Background: This study aimed to assess whether the presence of psychiatric co-morbidity impacts reoperation rates or the ability to complete routine follow-up after open reduction and internal fixation (ORIF) of distal radius fractures. Methods: A retrospective cohort study was performed of all patients who underwent distal radius ORIF with a volar locking plate between January 2012 and December 2016 at two Level I trauma centres. Presence of a psychiatric diagnosis at the time of injury was recorded. Bivariate analysis was utilised to compare patient characteristics, injury characteristics, reoperation rates and length of follow-up between those with and without psychiatric co-morbidity. Multivariable regression analysis was performed to identify whether psychiatric co-morbidity was predictive of reoperation or the ability to complete routine post-operative follow-up. Results: A total of 1,071 patients sustaining 1,110 distal radius fractures (39 bilateral injuries) met the inclusion criteria, of whom 338 patients (30.5%) had a psychiatric diagnosis at the time of injury. Bivariate analysis revealed a higher proportion of females in the psychiatric co-morbidity cohort (79% vs. 66%). There was no difference in reoperation rates (18% vs. 13%, p = 0.10) nor length of follow-up (12.8 months vs. 14.3 months, p = 0.67) between the psychiatric co-morbidity and control cohorts. Multivariable logistic regression revealed that the presence of psychiatric co-morbidity did not independently predict reoperation rate nor length of follow-up. Conclusions: The presence of psychiatric co-morbidity does not affect post-operative follow-up or need for revision surgery after distal radius ORIF. Level of Evidence: Level IV (Therapeutic).