Table 2.
Model-estimated SMFA and EQ-5D-3L scores following open tibia fracture, and comparison between orthopaedic treatments
|
SMFA (posterior mean, 95% highest density interval) |
EQ-5D-3L (posterior mean, 95% highest density interval) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Week 0 | Week 6 | Week 12 | Week 24 | Week 52 | Week 0 | Week 6 | Week 12 | Week 24 | Week 52 | |
| Overall | ||||||||||
| Gustilo grade I–II | 1·0 (0·7 to 1·3) | 39·4 (37·4 to 41·4) | 29·0 (27·2 to 30·8) | 17·7 (16·3 to 19·2) | 10·5 (9·5 to 11·6) | 0·98 (0·96 to 0·99) | 0·56 (0·54 to 0·57) | 0·61 (0·59 to 0·63) | 0·71 (0·69 to 0·73) | 0·80 (0·78 to 0·82) |
| Gustilo grade III | 1·6 (1·1 to 2·1) | 48·7 (46·1 to 51·4) | 37·4 (35·1 to 39·7) | 24·1 (22·1 to 26·1) | 14·9 (13·4 to 16·6) | 0·97 (0·96 to 0·98) | 0·49 (0·47 to 0·51) | 0·55 (0·53 to 0·57) | 0·65 (0·63 to 0·67) | 0·73 (0·70 to 0·75) |
| Difference (grade III vs grade I–II) | 0·6 (0·2 to 1·1) | 9·3 (5·8 to 12·7) | 8·4 (5·3 to 11·6) | 6·4 (4·0 to 8·8) | 4·4 (2·7 to 6·1) | −0·01 (−0·01 to 0·00) | −0·06 (−0·09 to −0·04) | −0·06 (−0·09 to −0·04) | −0·06 (−0·09 to −0·04) | −0·07 (−0·10 to −0·05) |
| Gustilo grade I–II injury | ||||||||||
| Nail | 0·5 (0·2 to 1·3) | 37·0 (33·3 to 40·6) | 22·0 (19·3 to 24·8) | 11·2 (9·3 to 13·4) | 7·3 (5·8 to 8·9) | 0·98 (0·96 to 0·99) | 0·58 (0·55 to 0·60) | 0·63 (0·60 to 0·65) | 0·74 (0·72 to 0·77) | 0·82 (0·79 to 0·84) |
| POP (tertiary) | 1·5 (0·7 to 2·6) | 39·0 (33·4 to 44·8) | 25·6 (19·8 to 31·4) | 11·5 (8·5 to 15·1) | 7·2 (4·7 to 10·1) | 0·98 (0·96 to 0·99) | 0·58 (0·54 to 0·62) | 0·64 (0·60 to 0·68) | 0·77 (0·73 to 0·81) | 0·87 (0·82 to 0·91) |
| POP (district) | 2·5 (1·5 to 4·1) | 47·5 (43·1 to 51·7) | 37·5 (33·5 to 41·6) | 20·9 (17·7 to 24·3) | 11·9 (9·6 to 14·4) | 0·98 (0·96 to 0·99) | 0·54 (0·51 to 0·57) | 0·59 (0·56 to 0·62) | 0·72 (0·69 to 0·75) | 0·81 (0·77 to 0·84) |
| Difference (dPOP vs tPOP) | 1·1 (−0·4 to 2·8) | 8·7 (1·0 to 16·1) | 11·8 (4·4 to 19·2) | 9·4 (4·7 to 14·1) | 4·8 (1·0 to 8·2) | 0·00 (−0·01 to 0·00) | −0·04 (−0·09 to 0·00) | −0·05 (−0·09 to 0·00) | −0·05 (−0·09 to −0·01) | −0·06 (−0·10 to −0·01) |
| Difference (nail vs tPOP) | −1·0 (−2·2 to 0·1) | −2·0 (−9·2 to 5·1) | −3·8 (−10·4 to 2·7) | −0·4 (−4·5 to 3·6) | 0·1 (−3·1 to 3·2) | 0·00 (−0·01 to 0·00) | 0·00 (−0·05 to 0·04) | −0·01 (−0·06 to 0·03) | −0·03 (−0·06 to 0·01) | −0·05 (−0·09 to −0·01) |
| Difference (nail vs dPOP) | −2·0 (−3·7 to −0·8) | −10·6 (−16·8 to −4·5) | −15·5 (−21·1 to −10·0) | −9·7 (−13·9 to −5·7) | −4·6 (−7·6 to −1·6) | 0·00 (0·00 to 0·00) | 0·04 (0·00 to 0·07) | 0·04 (0·00 to 0·07) | 0·03 (−0·01 to 0·06) | 0·01 (−0·03 to 0·05) |
| Gustilo grade III injury | ||||||||||
| External fixator | 1·4 (0·8 to 2·3) | 52·2 (48·0 to 56·4) | 41·2 (37·1 to 45·2) | 35·0 (30·8 to 39·1) | 19·7 (16·3 to 23·3) | 0·96 (0·92 to 0·98) | 0·46 (0·42 to 0·50) | 0·52 (0·49 to 0·56) | 0·59 (0·56 to 0·63) | 0·69 (0·65 to 0·73) |
| Nail | 0·6 (0·2 to 1·6) | 39·0 (34·6 to 43·5) | 28·2 (24·6 to 32·1) | 15·5 (12·9 to 18·5) | 8·4 (6·5 to 10·6) | 0·97 (0·93 to 0·99) | 0·55 (0·52 to 0·59) | 0·61 (0·58 to 0·65) | 0·68 (0·65 to 0·71) | 0·77 (0·73 to 0·81) |
| Amputation | 2·7 (1·0 to 5·6) | 48·3 (38·9 to 57·8) | 41·6 (33·3 to 50·4) | 38·5 (30·9 to 47·2) | 31·9 (25·0 to 39·9) | 0·95 (0·91 to 0·98) | 0·45 (0·40 to 0·51) | 0·52 (0·46 to 0·58) | 0·59 (0·53 to 0·65) | 0·68 (0·61 to 0·75) |
| POP (district) | 4·7 (1·3 to 10·9) | 46·8 (31·6 to 61·7) | 42·8 (28·3 to 58·2) | 37·1 (23·6 to 52·2) | 28·8 (17·5 to 42·6) | 0·95 (0·90 to 0·98) | 0·52 (0·42 to 0·62) | 0·59 (0·49 to 0·68) | 0·65 (0·56 to 0·74) | 0·72 (0·63 to 0·82) |
| Difference (dPOP vs amputation) | 1·9 (−2·3 to 8·1) | −2·0 (−19·0 to 16·2) | 1·0 (−16·3 to 18·0) | −1·5 (−17·7 to 15·8) | −3·1 (−17·4 to 12·4) | 0·00 (−0·05 to 0·03) | 0·07 (−0·04 to 0·17) | 0·07 (−0·04 to 0·17) | 0·06 (−0·04 to 0·16) | 0·05 (−0·07 to 0·16) |
| Difference (external fixator vs amputation) | −1·3 (−4·3 to 0·5) | 3·9 (−6·7 to 14·6) | −0·5 (−10·6 to 9·5) | −3·5 (−13·4 to 5·6) | −12·3 (−21·2 to −4·3) | 0·00 (−0·01 to 0·03) | 0·01 (−0·06 to 0·07) | 0·00 (−0·06 to 0·07) | 0·01 (−0·06 to 0·07) | 0·01 (−0·07 to 0·09) |
| Difference (nail vs amputation) | −2·0 (−5·0 to −0·2) | −9·3 (−19·9 to 1·7) | −13·4 (−23·4 to −3·8) | −23·0 (−32·3 to −14·5) | −23·4 (−31·7 to −16·2) | 0·01 (0·00 to 0·04) | 0·10 (0·04 to 0·16) | 0·10 (0·03 to 0·16) | 0·09 (0·03 to 0·15) | 0·09 (0·01 to 0·16) |
| Difference (external fixator vs dPOP) | −3·2 (−9·4 to 0·2) | 5·8 (−10·2 to 21·6) | −1·5 (−17·7 to 14·1) | −2·2 (−17·6 to 12·1) | −9·1 (−23·5 to 3·1) | 0·00 (−0·01 to 0·06) | −0·06 (−0·16 to 0·04) | −0·07 (−0·16 to 0·04) | −0·06 (−0·15 to 0·04) | −0·03 (−0·14 to 0·07) |
| Difference (nail vs dPOP) | −3·9 (−10·2 to −0·5) | −7·6 (−22·7 to 7·8) | −14·5 (−30·5 to 0·5) | −21·6 (−37·1 to −7·4) | −20·4 (−34·5 to −8·8) | 0·01 (−0·01 to 0·06) | 0·03 (−0·07 to 0·13) | 0·03 (−0·07 to 0·13) | 0·03 (−0·06 to 0·13) | 0·05 (−0·06 to 0·14) |
| Difference (nail vs external fixator) | −0·7 (−1·7 to 0·4) | −13·3 (−20·2 to −6·3) | −13·0 (−19·2 to −6·6) | −19·6 (−24·9 to −13·9) | −11·2 (−15·5 to −6·8) | 0·01 (0·00 to 0·02) | 0·09 (0·05 to 0·14) | 0·09 (0·05 to 0·13) | 0·09 (0·05 to 0·13) | 0·08 (0·03 to 0·13) |
Nail refers to the Surgical Implant Generation Network (known as SIGN) intramedullary nail. For all models, age is held constant at its mean, and days to initial surgical intervention at its median, and included participant-level random effects. EQ-5D-3L=European Quality of Life 5-Dimensions 3-Levels. POP=plaster of Paris. dPOP=plaster of Paris applied in district hospitals. tPOP=plaster of Paris applied in tertiary hospitals. SMFA=Short-Musculoskeletal Assessment Score.