What does this research mean for the field?

The Charlson Comorbidity Index (CCI) and Charlson Fracture Index (CFI) do not significantly differ in their ability to predict postoperative complications after open reduction and internal fixation of distal radius fractures. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to evaluate the effectiveness of the Charlson comorbidity index and the comorbidity fracture-specific index in predicting surgical complications after distal radius fracture surgery.

March 13, 2026Open Access

Association of Charlson Comorbidity Index and Charlson Fracture Index With Surgical Complications in Distal Radius Fractures: A Retrospective Review

APAmber M. ParkerMassachusetts General Hospital NGNicholas GenoveseBeth Israel Deaconess Medical Center AIAlexy IlchukBeth Israel Deaconess Medical Center

Key Points

The study aims to evaluate the effectiveness of the Charlson comorbidity index and the comorbidity fracture-specific index in predicting surgical complications after distal radius fracture surgery.
Conducted a single-center retrospective cohort study involving patients aged 40 and older who underwent open reduction and internal fixation for closed distal radius fractures.
Calculated Charlson comorbidity index and comorbidity fracture-specific index scores based on comorbid conditions over the past 15 years.
Analyzed 90-day postoperative complications using logistic regression, adjusting for age, sex, smoking status, and ethnicity.
Assessed the correlation between CCI and CFI using Pearson correlation and intraclass correlation coefficient.
16.7% of the 317 patients experienced postoperative complications.
No significant differences were found in CCI or CFI scores between patients with and without complications.
Both CCI and CFI increased the odds of complications with each unit increase, but findings were not statistically significant.
Strong correlation and high agreement were observed between CCI and CFI scores.

Abstract

Purpose: To assess and compare the associative value of comorbidity fracture-specific index (CFI) versus the Charlson comorbidity index (CCI) in identifying patients at risk for early complications after open reduction and internal fixation (ORIF) of distal radius fractures (DRFs).Methods: We performed a single-center retrospective cohort study including patients 40 years who underwent ORIF for closed DRF using a volar locking plate with a minimum of 1 year follow-up.CCI and CFI scores were calculated based on comorbidities over the prior 15 years.The primary outcome was 90day postoperative complications.We used logistic regression to compare CCI and CFI and their association with complications, adjusting for age, sex, smoking status, and ethnicity.We used Pearson correlation and the intraclass correlation coefficient to assess the relationship and agreement between CCI and CFI.Results: Among the 317 patients, 16.7% (n = 53) experienced complications.There were no statistically significant differences in CCI or CFI in patients with and without complications.After adjusting for covariates, each increase by 1 in CCI and CFI, increased the odds of complications; however, these effects were not statistically significant.CCI and CFI were strongly correlated and showed high agreement.Conclusions: CCI and CFI scores did not significantly differ between patients with and without complications after DRF and were not significantly associated with postoperative complications after adjusting for covariates.The strong correlation and agreement between CCI and CFI suggest they capture a similar comorbidity burden in this patient population.Neither CCI nor CFI demonstrated good discriminative ability in identifying patients at risk for early complications after ORIF of DRF.

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