Operative timing for open distal radius fractures and infection outcomes
| Adults (≥18 years) |
| Population with open distal radius fracture |
| Study evaluates operative debridement or fixation of open distal radius fracture |
| Randomized controlled trials or prospective or retrospective cohort studies or case-control studies |
| Primary research published in peer-reviewed journals |
| Case reports |
| Case series of fewer than five patients |
| Editorials |
| Commentaries |
| Letters |
| Narrative reviews |
| Conference abstracts |
| Conference posters |
| Animal studies |
| Cadaveric or roentgenographic studies |
| Exclusively nonoperatively managed open distal radius fractures |
| Open fractures at anatomic sites other than the distal radius without separately reported open distal-radius data |
| Duplicate publications of the same study cohort |
Locate the arms in methods text defining early versus delayed cohorts, cohort-assignment or randomization tables, and table column headers for time to surgery. Dimension (continuous) — time from injury or presentation to operative debridement or definitive fixation; a group whose cutpoint matches no declared arm is off-axis.
Operative debridement or fixation at or before 6 hours from injury or presentation, including ≤6 h, <6 h, 'within 6 hours', and 'early ≤6 h'.
Operative debridement or fixation after 6 hours from injury or presentation, including >6 h, ≥6 h when used as the delayed side of a 6-hour cut, and 'delayed >6 h'.
Operative debridement or fixation at or before 24 hours from injury or presentation, including ≤24 h, <24 h, 'within 24 hours', and 'early ≤24 h'.
Operative debridement or fixation after 24 hours from injury or presentation, including >24 h, ≥24 h when used as the delayed side of a 24-hour cut, and 'delayed >24 h'.
Operative debridement or fixation between 24 and 72 hours from injury or presentation, including 24–72 h, '>24 h and ≤72 h', and 'intermediate 24-72 h'.
Operative debridement or fixation after 72 hours from injury or presentation, including >72 h, ≥72 h, and 'delayed >72 h'.
Operative debridement or fixation after 2 days from injury or presentation, including >2 days, ≥2 days, '>48 h', and 'delayed beyond 2 days'.
| deep_infection | Deep surgical site infection requiring operative irrigation and debridement, intravenous antibiotics, hardware removal for infection, or a diagnosis of osteomyelitis; infection-related reoperation is counted within this composite. Exclude an infection the paper neither calls deep nor ties to operative irrigation and debridement, intravenous antibiotics, hardware removal, or osteomyelitis — exclude it even when the paper counts it among its infections or defines infection more broadly — and state in the deep_infection_rate comment how many such cases the paper reports; mark that rate ambiguous when the exclusion leaves events at 0. |
| superficial_ssi | Superficial surgical site infection treated with oral antibiotics only, without surgery. |
| reoperation_noninfectious | Reoperation unrelated to infection or the index irrigation and debridement, including loss of fixation, nonunion, malunion, or other mechanical complications. events counts patients who underwent at least one such reoperation. When the paper reports a number of procedures rather than a number of patients (e.g. 'total number of revision surgeries'), put that number in events, mark the rate ambiguous, and state in the comment that the figure counts procedures. |
| reoperation_total | All-cause reoperation count as reported by the paper, including infection-related and noninfectious reoperations. When only a total is reported and infection-related events cannot be subtracted, record the total here and leave reoperation_noninfectious not_reported. |
| crps | Complex regional pain syndrome following injury or surgery; record only under this outcome, not under nerve_complications. |
| tendon_complications | Tendon rupture, adhesion, attrition, or other tendon injury attributed to the fracture or its treatment. |
| nerve_complications | Nerve injury or neuropathy attributed to the fracture or its treatment; do not count CRPS here. |
| nonunion | Failure of fracture union as defined by the study authors. |
| malunion | Healed fracture with malalignment or deformity as defined by the study authors. |
| time_to_union | Time from injury or surgery to radiographic or clinical fracture union. |
| hardware_failure | Breakage, loosening, or other mechanical failure of fixation implants. |
| patient_reported_function | Patient-reported wrist or upper-extremity function on a named instrument such as DASH, QuickDASH, or PRWE. |