{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:15:37Z","timestamp":1777662937048,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The study aims to classify complications of open reduction and internal fixation (ORIF) of distal radius fractures, to determine risk factors of complications, and to validate a Clavien-Dindo scale modified for distal radius ORIF (mCD-DR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients undergoing distal radius ORIF at a single institution were retrospectively reviewed. Demographics, comorbidities, surgery length, and complications were collected. Complications were graded using the mCD-DR: Grade 1 is deviation from standard postoperative requirements, grade 2 requires additional pharmacologic management or monitoring, grade 3 requires procedural intervention, grade 4 includes life-threatening medical problems, and grade 5 is death. Two reviewers blindly graded complications, and agreement was determined using Cohen kappa coefficient. Logistic regression assessed predictors of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 160 patients were included: 112 (70.0%) women and 48 (30.0%) men. Sixty patients (37.5%) experienced a total of 67 complications. There were 25 (33.3%) grade 1, 12 (16.0%) grade 2, and 38 (50.7%) grade 3 complications. The most common complications were removal of hardware (22.7%), wrist injections (17.3%), and hand or wrist stiffness (9.3%). Blinded grading demonstrated near-perfect intra- and interrater agreement, with kappa coefficients of 0.95 to 0.97 and 0.87 to 0.95, respectively. Regression analysis revealed that longer surgeries, moderate Charlson Comorbidity Index, above-median age, and use of general anesthesia were predictive of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The mCD-DR identified an overall complication rate of 37.5% following distal radius ORIF, with grade 3 complications being the most common. Near-perfect agreement was observed among raters, demonstrating the reliability of the scale for classifying complications following distal radius ORIF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447261415644","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T08:34:06Z","timestamp":1770021246000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the Clavien-Dindo Classification System for Complications Following Open Reduction and Internal Fixation of Distal Radius Fractures"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4669-0097","authenticated-orcid":false,"given":"Alexis","family":"Driscoll","sequence":"first","affiliation":[{"name":"Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Fucaloro","sequence":"additional","affiliation":[{"name":"Boston Medical Center, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Stucky","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Bragg","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Guenthner","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Cassidy","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Salzler","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.3497"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2012.02.001"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1685205"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2023.05.033"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2024.09.014"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620x.96b7.33149"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-21-00719"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2023.04.008"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513510677"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2343-2"},{"issue":"5","key":"e_1_3_2_12_2","first-page":"518","article-title":"Proposed classification of complications of surgery with examples of utility in cholecystectomy","volume":"111","author":"Clavien PA","year":"1992","unstructured":"Clavien PA, Sanabria JR, Strasberg SM. 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