Complications following open distal radius fractures

Background: Open wrist fractures are rare comprising approximately 2.4 people per 100,000 per year, with little known about their complications. This retrospective study reports on all open wrist fractures presenting to a major trauma centre over a 7-year period.

Methods: From June 2007 to June 2014, all patients attending a major trauma centre with a distal radius fracture were identified. The clinical details were reviewed and the patients with open fractures identified. The radiographs and notes were then reviewed. The injuries were classified using the Gustilo and Anderson classification and the fractures by the Frykman classification system.

Results: There were 34 open wrist fractures. All patients underwent surgical debridement and fixation. Fixation comprised open reduction and internal fixation (27 pts), kirschner wire fixation (3 pts), external fixation with additional kirschner wires (1 pt), and external fixation alone (3 pts). Fixation took place a mean of 13.8 hours (SD: 9.7, range: 2.1 to 46.7) after arrival in hospital. There were 10 complications in 10 patients (29%). Overall 7 patients (21%) required further surgery.

Conclusion: The rate of infection is low; however, the rate of re-operation is high. Patients with open wrist fractures should be made aware, early in their management, of the high risk of further surgery.