D97. The Impact of Human Immunodeficiency Virus and Antiretroviral Therapy Status on Distal Radius Fractures Management and Complications

PURPOSE: Approximately 1.2 million people in US are living with positive human immunodeficiency virus (HIV) status. The advent of anti-retroviral therapy (ART) has increased the life expectancy of HIV-positive individuals, however, increased risk of fracture has become eminent in this population. Our study investigates whether HIV and ART status impact distal radius fracture management, post-fixation complications and complications. METHODS: A retrospective national database review with PearlDiver was performed. Exclusion criteria were age <18 years, <1 year of database follow-up, and additional upper extremity fractures. Patients with a distal radius fracture (DRF) between 2016 and 2022 were identified and stratified into three groups (HIV-negative, HIV receiving ART and HIV without ART). Treatment method (closed or open), complications and reoperations within 1 year of surgery were identified. RESULTS: The HIV-positive without ART group was less likely to receive open treatment (OR=0.82, CI (0.69, 0.96), p=0.018); following closed treatment, the rate of this population undergoing reoperation for malunion and nonunion after closed treatment (1.1%) is significantly higher than HIV-negative patients (0.6%, p=0.03). Both ART and none-ART groups had significantly higher rates of malunion and nonunion following open treatment (5 and 6.5%) compared to HIV-negative patients (2.2%, p<0.01). CONCLUSION: Our results indicate lower rate of open treatment for HIV-positive patients without ART; and HIV-positive status appears to complicate both types of DRF fixation regardless of ART status. Overall, our results indicate a need for closer surveillance of HIV-positive patients, as well as further research into the interplay of HIV status, ART and bone healing.