Abstract：
BACKGROUND: Despite the prevalence of renal impairments, the existing literature examining fracture healing in the upper limb in patients with renal impairment is sparse. This study hence aims to investigate the effect of renal impairment on time to fracture healing after distal radius fracture fixation surgery.
METHODS: Patients above 50 years old who underwent distal radius fracture fixation via volar plating were included. Time to fracture healing was defined as duration between day of surgery and presence of radiographic union as evidence by bridging of callus or osseous bone. To assess for renal impairment, estimated glomerular filtration rate (eGFR) was calculated based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Pre-existing comorbidities were also collected and analysed.
RESULTS: Ninety-nine consecutive patients took mean 65.5 ± 8.0 days to fracture healing post-operatively. Patients with renal impairment had longer time to fracture healing than patients without (67.1 ± 50.4 days versus 50.4 ± 31.8 days, p = 0.044). Patients ≥ 65 years also had a longer duration to fracture healing compared to patients < 65 years (mean 63.7 ± 53.0 days versus 50.2 ± 27.2 days, p = 0.033). Similarly, patients with ASA Class I had a shorter mean time to fracture healing than patients with ASA Class II and above (mean 42.5 ± 22.8 days versus 62.8 ± 47.6 days, p = 0.028).
CONCLUSIONS: Time to fracture healing post-distal radius fracture fixation was significantly related to renal impairment, age and ASA classification.
METHODS: Patients above 50 years old who underwent distal radius fracture fixation via volar plating were included. Time to fracture healing was defined as duration between day of surgery and presence of radiographic union as evidence by bridging of callus or osseous bone. To assess for renal impairment, estimated glomerular filtration rate (eGFR) was calculated based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Pre-existing comorbidities were also collected and analysed.
RESULTS: Ninety-nine consecutive patients took mean 65.5 ± 8.0 days to fracture healing post-operatively. Patients with renal impairment had longer time to fracture healing than patients without (67.1 ± 50.4 days versus 50.4 ± 31.8 days, p = 0.044). Patients ≥ 65 years also had a longer duration to fracture healing compared to patients < 65 years (mean 63.7 ± 53.0 days versus 50.2 ± 27.2 days, p = 0.033). Similarly, patients with ASA Class I had a shorter mean time to fracture healing than patients with ASA Class II and above (mean 42.5 ± 22.8 days versus 62.8 ± 47.6 days, p = 0.028).
CONCLUSIONS: Time to fracture healing post-distal radius fracture fixation was significantly related to renal impairment, age and ASA classification.
摘要：
背景：尽管肾功能损害很普遍，现有文献对肾功能损害患者上肢骨折愈合的研究较少。因此，本研究旨在研究肾功能损害对桡骨远端骨折固定手术后骨折愈合时间的影响。
方法：纳入50岁以上经掌侧钢板固定桡骨远端骨折患者。骨折愈合时间定义为手术当天与影像学结合之间的持续时间，以此作为骨痂或骨骨桥接的证据。为了评估肾功能损害，估算的肾小球滤过率(eGFR)是根据慢性肾脏病流行病学合作(CKD-EPI)方程计算的.还收集并分析了先前存在的合并症。
结果：99例连续患者术后平均骨折愈合时间为65.5±8.0天。肾功能损害患者骨折愈合时间长于无（67.1±50.4天对50.4±31.8天，p=0.044)。与<65岁的患者相比，≥65岁的患者骨折愈合时间也更长（平均63.7±53.0天对50.2±27.2天，p=0.033)。同样，ASAI级患者的平均骨折愈合时间比ASAII级及以上患者短（平均42.5±22.8天对62.8±47.6天，p=0.028)。
结论：桡骨远端骨折固定后骨折愈合时间与肾功能损害显著相关，年龄和ASA分类。
方法：纳入50岁以上经掌侧钢板固定桡骨远端骨折患者。骨折愈合时间定义为手术当天与影像学结合之间的持续时间，以此作为骨痂或骨骨桥接的证据。为了评估肾功能损害，估算的肾小球滤过率(eGFR)是根据慢性肾脏病流行病学合作(CKD-EPI)方程计算的.还收集并分析了先前存在的合并症。
结果：99例连续患者术后平均骨折愈合时间为65.5±8.0天。肾功能损害患者骨折愈合时间长于无（67.1±50.4天对50.4±31.8天，p=0.044)。与<65岁的患者相比，≥65岁的患者骨折愈合时间也更长（平均63.7±53.0天对50.2±27.2天，p=0.033)。同样，ASAI级患者的平均骨折愈合时间比ASAII级及以上患者短（平均42.5±22.8天对62.8±47.6天，p=0.028)。
结论：桡骨远端骨折固定后骨折愈合时间与肾功能损害显著相关，年龄和ASA分类。
