Risk of secondary surgery following surgical treatment of fractures: a nationwide register study on 9,719 adult patients

BACKGROUND AND PURPOSE: Reports on the risk of secondary surgery in fracture-related surgery are scarce in the literature. The aim of this study was to estimate the risk of any secondary musculoskeletal surgery within 2 years of primary, fracture-related surgery.

METHODS: We performed a nationwide register study on adult Danish patients surgically treated for fractures in 2016 with 2 years' follow-up. We used cross-linked data from the Danish Fracture Database, the Danish National Patient Registry and the Danish Civil Registration System. Primary outcome was risk of secondary surgery calculated by the cumulative incidence function and presented with 95% confidence intervals (CI) overall and stratified on age, sex, and anatomical area.

RESULTS: We included 9,719 adult patients of whom 63% were female and median age was 70 years (20-100). The overall risk of secondary musculoskeletal surgery in the same anatomical area as the primary was 20% (CI 19-21), for reoperation (i.e., pertaining to the initial treatment) 19% (CI 18-20), and for major reoperation (due to complication of the initial treatment) 8% (CI 7-8). Across anatomical areas risk ranged from 4% (CI 1-9) to 69% (CI 66-73) for secondary surgery, from 4% (CI 1-9) to 68% (CI 65-72) for reoperations, and from 2% (CI 0-6) to 26% (CI 19-33) for major reoperation.

CONCLUSION: The risk of experiencing a major postoperative complication that needs surgical treatment is below 10%.