Comparable healing, divergent function in tibia diaphyseal fractures stratified by age

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI:10.1016/j.jcot.2026.103376

Alexander M. Lashgari , Abhishek Ganta , Kenneth A. Egol , Sanjit Konda

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引用次数: 0

Abstract

Background

This study aimed to compare union rates of tibia shaft fractures in two age groups: patients younger than 65 and those 65 or older. Secondary aims included comparing quality measures and functional outcomes.

Methods

A retrospective review at a single multi-site urban academic institution was conducted. Inclusion criteria included: age ≥18, isolated OTA 42A to 42C tibia shaft fracture treated with an intramedullary nail, and follow-up ≥6 months. The primary outcome was fracture union, defined as RUST score >7. Functional outcome was measured by the Functional Ambulatory Category (FAC) score (0 = nonfunctional, 5 = independent ambulation). Patients were grouped as young (<65) or elderly (≥65). Univariate and multivariate analyses controlled for confounders.

Results

Of 286 patients, 253 were young (mean age 38.9 ± 12.9 years) and 33 elderly (mean age 71.2 ± 6.4 years). Mean follow-up was 13.6 ± 7.9 months. Union rates (94.0% elderly vs. 89.3% young, p = 0.409) and time to union (6.4 vs. 6.1 months, p = 0.647) did not differ. Readmission (18.2% vs. 8.3%, p = 0.069) and complication rates (21.2% vs. 19.0%, p = 0.759) were also similar. After adjusting for baseline FAC, sex, BMI, CCI, fracture type, and injury mechanism, older age was associated with lower FAC scores at three (B = −0.460, 95% CI [-0.826, −0.094], p = 0.014), six (B = −0.371, 95% CI [-0.679, −0.063], p = 0.019), and twelve months (B = −0.317, 95% CI [-0.552, −0.082], p = 0.009).

Conclusions

Elderly patients with tibia shaft fractures treated with intramedullary nails achieve similar union rates and healing times as younger patients. However, older age independently predicts reduced ambulatory function post-injury.

Abstract Image

查看原文本刊更多论文

按年龄分层的胫骨骨干骨折可比较愈合，功能分化。

背景：本研究旨在比较两个年龄组的胫骨干骨折愈合率：65岁以下的患者和65岁以上的患者。次要目的包括比较质量测量和功能结果。方法：对一所城市学术机构进行回顾性研究。纳入标准为：年龄≥18岁，髓内钉治疗孤立性OTA 42A - 42C胫骨干骨折，随访≥6个月。主要结局是骨折愈合，定义为RUST评分bb70。功能结局通过功能活动分类（FAC）评分来衡量（0 =无功能，5 =独立活动）。结果：286例患者中，青年253例（平均年龄38.9±12.9岁），老年33例（平均年龄71.2±6.4岁）。平均随访13.6±7.9个月。愈合率（94.0%老年人对89.3%年轻人，p = 0.409）和愈合时间（6.4个月对6.1个月，p = 0.647）无差异。再入院率（18.2%比8.3%,p = 0.069）和并发症发生率（21.2%比19.0%,p = 0.759）也相似。在调整基线FAC、性别、BMI、CCI、骨折类型和损伤机制后，年龄越大，3个月（B = -0.460, 95% CI [-0.826, -0.094], p = 0.014）、6个月（B = -0.371, 95% CI [-0.679, -0.063], p = 0.019）和12个月（B = -0.317, 95% CI [-0.552, -0.082], p = 0.009）时FAC评分越低。结论：老年胫骨干骨折采用髓内钉治疗，其愈合率和愈合时间与年轻患者相似。然而，老年独立预测损伤后运动功能下降。

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

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.