J Wrist Surg
DOI: 10.1055/s-0043-1761295
Scientific Article

The Association between Bleeding Disorders and Postoperative Complications Following Operative Treatment of Distal Radius Fracture

1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
Frank R. Chen
2   Department of Anesthesiology, Hospital of the University of Pennsylvania, Pennsylvania
Joseph E. Manzi
3   Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York
Lea Mcdaniel
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
Peter Howard
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
Caillin Marquardt
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
Rachel Ranson
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
Sean Tabaie
4   Department of Orthopaedic Surgery, Children's National Health System, Washington, District of Columbia
› Institutsangaben
Funding No funds, grants, or other support was received.


Background While previous studies have investigated the association between bleeding disorders and outcomes with hip or knee surgeries, no studies have investigated the association between bleeding disorders and outcomes in upper extremity surgery.

Questions/Purposes The purpose of this study was to investigate if a past history of bleeding disorders is associated with which, if any postoperative complications for patients receiving distal radius fracture open reduction internal fixation.

Patients and Methods Patients undergoing operative treatment for distal radius fracture from 2007 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients were stratified into two cohorts: patients with a bleeding disorder and patients without a bleeding disorder. In this analysis, 30-day postoperative complications were assessed, as well as mortality, extended length of stay, reoperation, and readmission. Bivariate and multivariate analyses were performed.

Results Of the 16,489 total patients undergoing operative treatment for distal radius fracture, 16,047 patients (97.3%) did not have a bleeding disorder, whereas 442 (2.7%) had a bleeding disorder. Following adjustment on multivariate analyses, an increased risk of postoperative transfusion requirement (odds ratio [OR] 17.437; p = 0.001), extended length of hospital stay more than 3 days (OR 1.564; p = 0.038), and readmission (OR 2.515; p < 0.001) were seen in patients with a bleeding disorder compared to those without a bleeding disorder.

Conclusion History of bleeding disorders is an independent risk factor for transfusions, extended length of stay, and readmission. We recommend a multidisciplinary team approach to addressing bleeding disorders before patients receive distal radius fracture open reduction internal fixation.

Level of Evidence Level III, retrospective study.

Financial Interests

The authors declare they have no financial interests.

Ethics Approval

Institutional review board approval was not required for this study as all data are de-identified and public.

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.


Eingereicht: 17. Mai 2022

Angenommen: 22. Dezember 2022

Artikel online veröffentlicht:
27. Januar 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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