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J Wrist Surg 2023; 12(04): 306-311
DOI: 10.1055/s-0042-1751079
Scientific Article

The Effect of Steroid Use on Complications after Distal Radius Fracture Repair

Theodore Quan 
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, Philadelphia, Pennsylvania
,
Peter Howard
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
,
Casey Gioia
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
,
Tom Pollard
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
,
Alex Gu
1   Department of Orthopaedic Surgery, The George Washington School of Medicine and Health Sciences, Washington, District of Columbia
,
Sean Tabaie
3   Department of Orthopaedic Surgery, Children's National Health System, Washington, District of Columbia
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Funding None.
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Abstract

Background Distal radius fractures (DRFs) are the most common fracture of the upper extremity. Given that steroids are one of the most commonly prescribed drugs and are usually prescribed for chronic conditions, steroid use represents a key factor to consider in how to optimize perioperative outcomes.

Questions/Purposes The purpose of this study was to investigate if there are differences in perioperative outcomes for patients undergoing DRF open reduction and internal fixation based on preoperative steroid use.

Patients and Methods Adult patients who underwent operative treatment for DRF from 2007 to 2018 were identified in a national database. Patients were divided into two cohorts as follows: (1) no steroid usage and (2) preoperative steroid usage. In this analysis, various postoperative complications, as well as extended length of stay and reoperation, were assessed. Bivariate analyses and multivariable logistical regression were performed.

Results Among a total of 16,505 patients undergoing operative treatment for DRF, 16,145 patients (97.8%) did not have steroid usage and 360 (2.2%) had steroid usage. Following adjustment, an increased risk of extended length of hospital stay greater than 3 days (odds ratio [OR] = 1.646; p = 0.012) was seen in the steroid usage group compared with those who did not use steroids within 30 days of surgery.

Conclusion Preoperative steroid use is associated with increased length of stay over 3 days after DRF open reduction and internal fixation surgery but is not associated with any of the other complications that were assessed in this study.

Level of Evidence This is a Level III, retrospective study.

Keywords

distal radius fracture - open reduction and internal fixation - steroid use - complications

Ethical Approval

Institutional review board approval was not required for this study, as all data are deidentified 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.


Note

The work was performed at The George Washington School of Medicine and Health Sciences, Washington, DC.




Publication History

Received: 03 April 2022

Accepted: 20 May 2022

Article published online:
06 July 2022

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