ArticleCureus2026
Factors Producing Variation in Postoperative Surveillance After Distal Radius Open Reduction and Internal Fixation: A Multi-surgeon Cohort Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Introduction Postoperative follow-up after open reduction and internal fixation (ORIF) of distal radius fracture varies widely, yet determinants of follow-up utilization are poorly understood. The purpose of this study was to evaluate the independent influence of surgeon-level factors versus patient sociodemographics on follow-up utilization. We hypothesized that, in a modern integrated health system, surgeon-specific practice infrastructure would be the primary driver of variability in follow-up. Methods This retrospective cohort study (2019-2024) analyzed adult distal radius ORIF patients within a single health system. Multivariable negative binomial regression evaluated patient demographics, comorbidities, insurance, and operating surgeon as predictors of postoperative follow-up frequency. Secondary outcomes included complications, including nerve, tendon, wound-related issues, and hardware removal. Surgeon identities were de-identified, with low-volume providers grouped as "Other". Results Among 731 patients (mean age: 55.3 years), the mean surgeon follow-up was 1.95±1.79 visits (range: 0-11). While 190 (26%) patients had zero encounters with the operating surgeon, all 731 (100%) patients received clinical surveillance via advanced practice providers (APPs). Multivariable regression identified female sex (incidence rate ratio (IRR): 1.26; 95% CI: 1.08-1.46; z=2.997; p=0.003) and private insurance (IRR: 1.31; 95% CI: 1.06-1.63; z=2.494; p=0.013) as independent predictors of higher utilization. Surgeon identity was the strongest predictor of follow-up frequency, with significant variation across providers (p<0.05). Although complications occurred in only 53 patients (7.3%), they were strongly associated with increased visits (IRR: 2.47; 95% CI: 2.14-2.85; z=12.37; p<0.001); however, complication rates did not fully account for the observed provider-level variability. Age, race, comorbidities, and smoking status were not significant predictors (p>0.05). Conclusion Postoperative follow-up utilization after distal radius ORIF demonstrates marked variability and is influenced by both patient- and provider-level factors. Surgeon-specific practice patterns play a substantial role in determining follow-up frequency.
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