Comparative Study of Early Health Care Use after Forearm Corrective Osteotomy

Abstract

Background Bone reconstruction is frequently required for corrective osteotomy of the forearm long bones. Studies have evaluated long term outcomes but not the impact of these procedures on early postoperative complications and health care utilization.

Questions/Purposes This study evaluated the early postoperative health care utilization following corrective osteotomy of the radius and/or ulna.

Patients and Methods The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) was the primary data source to perform a comparative statistical analysis of the bone autograft and nonautograft (allograft, graft substitute, or no graft) procedures. We performed a review of the NSQIP database (2005–2013) to evaluate patients who underwent a corrective osteotomy of the radius and/or ulna.

Results There were 362 cases; autograft (n = 117) and nonautograft (n = 245). There were no significant differences with demographics or comorbidities. The majority of cases were outpatient surgeries and there were no significant differences in anesthesia time, operative time, or hospital length of stay. Overall, the average length of stay was 0.6 days, readmission rate was 2%, and the total complication rate was 1% and there was no statistically significant difference between reconstruction groups. Harvesting of autograft was not associated with the overall 30-day complications and specific markers of health care utilization.

Conclusions Our results are derived from the heterogeneous hospital setting of NSQIP contributing centers. The health care utilization and 30-day complications are low following corrective osteotomy of forearm long bones and autograft harvest did not influence the health care utilization.

Level of Evidence Therapeutic Level II.

Keywords

osteotomy - bone graft - outcome - health care utilization metrics - radius - ulna

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