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Archives of Orthopaedic and Trauma Surgery

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01-06-2021 | Ankle Fracture | Orthopaedic Surgery

End-stage renal disease increases risk of postoperative complications after lower extremity fracture

Authors: Atsushi Endo, Michael F. McTague, Elizabeth Allen, Arvind von Keudell, Michael J. Weaver

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2021

Abstract

Introduction

End-stage renal disease (ESRD) leads to multiple systemic effects and patients suffer from multiple comorbidities including fractures. While previous studies have examined complications following hip fracture surgery in ESRD patients, there are no studies evaluating other lower extremity fractures. This study aimed to identify postoperative complication risk in patients with ESRD who had lower extremity fractures.

Methods

Using our database from 2000 to 2015 at two level-one trauma centres, we collected data on patients over age 40, who had lower extremity fractures and surgical fixation. Diagnosis of ESRD was made before the injury. Each ESRD patient was matched by two non-ESRD patients regarding age, gender, American Society of Anaesthesiologists (ASA) score, and AO/OTA fracture classification. Postoperative outcomes were non-union, mechanical failure, and infection. The number of outcome events was compared between the ESRD and non-ESRD cohorts.

Results

A total of 195 patients (65 ESRD patients matched to 130 non-ESRD patients) were identified. Median follow-up was 31 months (12–141 months). Patients with ESRD were 3.6 time more likely to have at least one postoperative complication (mechanical failure, non-union, or infection) compared to non-ESRD patients (9/65 vs. 5/130, p = 0.02). In particular, mechanical failure was eight times higher among ESRD patients compared to non-ESRD patients (8/65 vs. 2/130, p < 0.01).

Conclusions

ESRD was associated with higher rates of complications, especially mechanical failure, after lower extremity fracture surgeries.

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Title: End-stage renal disease increases risk of postoperative complications after lower extremity fracture
Authors: Atsushi Endo
Michael F. McTague
Elizabeth Allen
Arvind von Keudell
Michael J. Weaver
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keyword: Ankle Fracture
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2021
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03490-8

At a glance: The STEP trials

Springer Medicine

End-stage renal disease increases risk of postoperative complications after lower extremity fracture

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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