Anesthesia Type and Short-Term Outcomes in Open Treatment of Hand Fractures

Document Type : RESEARCH PAPER

Authors

Rutgers New Jersey Medical School Department of Orthopaedics, Newark, USA

Abstract

Objectives: The hand is one of the most commonly fractured parts of the body. Many of these injuries 
are treated operatively. This study compares short-term outcomes between general anesthesia and 
other forms of anesthesia in the open treatment of hand fractures.
Methods: Procedures related to the open treatment of carpal, metacarpal, and phalangeal fractures from the years 
2005-2017 were queried from the National Surgical Quality Improvement Program (NSQIP) database. Outcome 
measures included 30-day reoperation rate, length of stay (LOS), minor complications, and major complications. 
Chi-squared tests were used to identify significant demographics and comorbidities. Significant variables were 
included in a logistic regression model.
Results: A total of 5,907 patients were included, of which 4,547 (77%) received general anesthesia, and 1,360 
(23%) received local anesthesia, regional anesthesia, sedation, or monitored anesthesia care. Patients treated with 
general anesthesia were younger and more likely to be male. Operative time was longer with general anesthesia 
(65.0 vs. 59.8 minutes, P<0.01). Anesthesia technique had no statistically significant association with thirty-day rate 
of reoperation, minor complications, or major complications (P=0.32, 0.91, and 0.07, respectively). General 
anesthesia had greater odds for LOS exceeding the 75th percentile (OR 2.05, P<0.01).
Conclusion: In the open treatment of hand fractures, short-term complication rates are similar between general 
anesthesia and other forms of anesthesia, but extended LOS is more likely with general anesthesia. When practical, 
surgeons can consider local anesthesia, regional anesthesia, sedation, and monitored anesthesia as reasonably 
safe alternatives to general anesthesia.
 Level of evidence: III

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 12, Issue 10
October 2024
Pages 721-727

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History

  • Receive Date: 22 August 2022
  • Revise Date: 04 July 2024
  • Accept Date: 20 June 2024

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