Impact of Attention-Deficit/Hyperactivity Disorder on Postoperative Outcomes Following Open Reduction and Internal Fixation of Distal Radius Fractures

Abstract Distal radius fractures can be managed non-operatively or with open reduction and internal fixation (ORIF). Attention-deficit/hyperactivity disorder (ADHD) has been found to increase the rate of fractures, but it is unclear what role ADHD plays in postoperative outcomes for distal radius fractures. Our study aims to compare the differences in postoperative complications in patients undergoing distal radius fracture ORIF in those with and without ADHD. TriNexT, a global health database, was used to analyze patients who underwent ORIF following distal radius fracture. Outcomes were assessed at 6 months and 2 years postoperatively. Patients were 1:1 propensity-score matched following ORIF in ADHD versus non-ADHD cohorts. Differences in postoperative outcomes were assessed with relative risk. Statistical significance was set at p < 0.05. All statistical analyses were performed within TriNetX. There were 3,289 matched patients with and without ADHD who underwent ORIF of distal radius fractures. No statistically significant differences were observed between cohorts in rates of hardware-related infection, wound disruption, hardware removal, malunion and nonunion, emergency department (ED) visits, and sepsis at 6 months. Patients with ADHD demonstrated a significantly higher rate of hardware-related infection compared with matched patients at 2 years. No statistically significant differences were observed between cohorts in rates of wound disruption, hardware removal, malunion or nonunion, ED visits, or sepsis at 2 years. Overall, patients with ADHD undergoing distal radius fixation appear to have a limited increase in complications, with the only statistically significant finding being increased rates of hardware infection within 2 years.