• Comprehensive analysis of 45 studies reveals that diabetes, smoking, and osteoporosis significantly increase the risk of complications after wrist surgery.
• Surgical technique, including minimally invasive approaches, and early rehabilitation are critical in reducing tendon adhesion and stiffness.
• A structured risk stratification framework is proposed to guide individualized surgical planning and postoperative care.
• Evidence-based management strategies, including antibiotic prophylaxis and nerve decompression, can mitigate infection and nerve injury risks.