A Comparison of the Rates of Postoperative Infection Following Distal Radius Fixation Between Pediatric and Young Adult Populations: An Analysis of 32 368 Patients.

Background: Infection following surgical fixation of a distal radius fracture can markedly compromise a patient's functional outcome. This study aimed to compare infection rates in pediatric (5-14 years) and adolescent (15-17 years) patients undergoing fixation of a distal radius fracture to a cohort of young adult (18-30 years) patients.
Methods: A matched retrospective study was performed using PearlDiver to determine the rates of postoperative infection following distal radius fixation. χ ² and logistic regression were used to assess differences in rates, while linear regression was used to analyze rates of infection over time.
Results: In 32 368 patients, young adults experienced postoperative infection at a significantly increased rate (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.45-2.27). This trend was consistent among the male (OR = 1.96; 1.49-2.57) and female (OR = 2.11, 1.37-3.27) cohorts. In the multivariate model, the adult cohort remained at increased risk (OR = 1.40; 95% CI, 1.04-1.89), with open fracture (OR = 4.99; 3.55-6.87), smoking (OR = 1.76; 1.22-2.48), hypertension (OR = 1.69; 1.20-2.33), and obesity (OR = 1.37; 1.02, 1.80) identified as other significant risk factors. There was no significant change in the rate of postoperative infections over the 11-year study period.
Conclusion: This study demonstrated that although surgical site infections following distal radius fixation are low in patients aged 30 years or younger (0.97%), young adults develop infections at a significantly increased rate. This is important for surgeons to recognize when counseling patients on the risks of surgical fixation.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J.A.A., O.M., E.R., O.K., and E.J.T. do not report any disclosures. A.H.D. reports disclosures as follows: EOS, paid consultant; Orthofix, Inc., paid consultant, research support; SpineArt, paid consultant; Medtronic/Medicrea, paid consultant; Springer: publishing royalties, financial or material support; Stryker: paid consultant, all outside submitted work. A.I.C. reports disclosures as follows: POSNA, committee board member, PRiSM, committee board member.