RISK FACTORS AT NON-UNION OF TIBIAL FRACTURE TREATED WITH INTRAMEDULLARY NAIL.

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243202e278581

Vitor Lorens Yulta Abe Puccetti, Fernando Loureiro de Miranda, Caio Cesar Nogueira de Figueiredo, Kayo Augusto de Almeida Medeiros, Marcos de Camargo Leonhardt, Jorge Dos Santos Silva, Kodi Edson Kojima

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引用次数: 0

Abstract

Objective: Identify the predictors associated with delayed union at 6 months and non-union at 12 months in tibial shaft fractures treated with intramedullary nailing (IMN).

Methods: This retrospective longitudinal study included a cohort of 218 patients who sustained tibial shaft fractures and received IMN between January 2015 and March 2022. We gathered data on a range of risk factors, including patient demographics, trauma intensity, associated injuries, fracture characteristics, soft tissue injuries, comorbidities, addictions, and treatment-specific factors. We employed logistic bivariate regression analysis to explore the factors predictive of delayed union and non-union.

Results: At the 6-month follow-up, the incidence of delayed union was 28.9%. Predictors for delayed union included flap coverage, high-energy trauma, open fractures, the use of external fixation as a staged treatment, the percentage of cortical contact in simple type fractures, RUST score, and postoperative infection. After 12 months, the non-union rate was 15.6%.

Conclusion: the main predictors for non-union after IMN of tibial shaft fractures are related to the trauma energy. Furthermore, the initial treatment involving external fixation and postoperative infection also correlated with non-union. Level of Evidence III; Retrospective Longitudinal Study.

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用髓内钉治疗的胫骨骨折不愈合的风险因素。

目的确定与髓内钉（IMN）治疗胫骨干骨折 6 个月延迟愈合和 12 个月不愈合相关的预测因素：这项回顾性纵向研究纳入了 2015 年 1 月至 2022 年 3 月间发生胫骨轴骨折并接受髓内钉治疗的 218 例患者。我们收集了一系列风险因素的数据，包括患者人口统计学特征、创伤强度、相关损伤、骨折特征、软组织损伤、合并症、成瘾以及治疗特异性因素。我们采用逻辑双变量回归分析来探讨预测延迟愈合和不愈合的因素：结果：在6个月的随访中，延迟愈合的发生率为28.9%。延迟愈合的预测因素包括皮瓣覆盖、高能量创伤、开放性骨折、使用外固定作为分期治疗、简单型骨折的皮质接触百分比、RUST评分和术后感染。12个月后，不愈合率为15.6%。结论：胫骨轴骨折IMN术后不愈合的主要预测因素与创伤能量有关。此外，最初的外固定治疗和术后感染也与不愈合有关。证据等级 III；回顾性纵向研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.