Abstract / Summary
Abstract Purpose To determine whether solid organ transplant recipients receiving immunosuppressive therapy have delayed fracture healing and a higher rate of postoperative complications after surgically treated fractures from acute trauma, compared with matched non-transplant patients. Methods The trauma database of a Swiss level I trauma center was reviewed for immunosuppressed solid organ transplant recipients who sustained a fracture from acute trauma and were treated with osteosynthesis between 2008 and 2022. Fracture healing time was compared with that of non-transplant control patients individually matched 1:1 for fracture type, treatment modality, age (± 5 years), and sex. Results A total of 35 patients with 44 fractures were included; 19 kidneys, ten lungs, six livers, two pancreas, and two hearts had been transplanted a mean of 110 (± 89) months before the index fracture. Mean age at injury was 54 (± 17) years, and mean follow-up was 86 (± 48) months. In the matched-pair analysis, fracture healing was significantly prolonged in transplant recipients (7.5 ± 7.8 months) compared with matched controls (2.8 ± 2.1 months; p < 0.001). Complications included one hematoma and one wound infection requiring surgical intervention; three fractures failed to unite and required reoperation but eventually healed. Conclusion Fracture healing was significantly delayed in solid organ transplant recipients under immunosuppressive therapy. Standard surgical fixation techniques remain appropriate, but rehabilitation protocols should be adapted to account for a substantially longer expected healing time in this population.