Table 3.
Outcomes of all adult trauma patients with long bone shaft fractures.
| Characteristic | All |
Femur |
Tibia/fibula |
Humerus |
|||
|---|---|---|---|---|---|---|---|
| (n = 358406) | (n = 146685) | p-value | (n = 158749) | p-value | (n = 69856) | p-value | |
| Outcomes | |||||||
| LOS, days, mean (SD) | 8.5 (11) | 9.3 (11) | <0.001 | 8.6 (11) | <0.001 | 8.5 (12) | <0.001 |
| ICU, days, mean (SD) | 7.7 (11) | 7.7 (9) | 0.23 | 7.8 (10) | <0.001 | 7.5 (9) | <0.001 |
| Ventilator, days, mean (SD) | 7.6 (6) | 4.0 (8) | <0.05 | 7.7 (10) | <0.001 | 8.1 (10) | <0.001 |
| Major surgery, n (%) | |||||||
| All | 178486 (49.8) | 116047 (79.1) | <0.001 | 117550 (74.0) | <0.001 | 36948 (52.9) | <0.001 |
| Application of external fixation device | 35123 (9.8) | 9109 (6.2) | <0.001 | 23729 (14.9) | <0.001 | 1173 (1.7) | <0.001 |
| Reconstructive operation | 1433 (0.4) | 251 (0.2) | <0.001 | 962 (0.6) | <0.001 | 65 (0.1) | <0.001 |
| Internal fixation without reduction | 15053 (4.2) | 11599 (3.2) | <0.001 | 8960 (5.6) | <0.001 | 924 (1.3) | <0.001 |
| Closed reduction without internal fixation | 22937 (6.4) | 8700 (5.9) | <0.001 | 1472 (0.9) | <0.001 | 5991 (8.6) | <0.001 |
| Closed reduction with internal fixation | 59853 (16.7) | 36251 (24.7) | <0.001 | 24548 (15.5) | <0.001 | 2110 (3.0) | <0.001 |
| Open reduction without internal fixation | 4301 (1.2) | 1326 (0.9) | <0.001 | 2856 (1.8) | <0.001 | 502 (0.7) | <0.001 |
| Open reduction with internal fixation | 168809 (47.1) | 68313 (46.6) | <0.001 | 79299 (50.0) | <0.001 | 29658 (42.5) | <0.001 |
| Debridement | 60212 (16.8) | 13917 (9.5) | <0.001 | 37366 (23.5) | <0.001 | 5520 (7.9) | <0.001 |
| Unspecified bone surgery | 71 (0.02) | 57 (0.1) | <0.001 | 39 (0.02) | <0.001 | 7 (0.01) | <0.001 |
| Complications, n (%) | |||||||
| Amputation through bone | 5017 (1.4) | 1862 (1.3) | <0.001 | 2436 (1.5) | <0.001 | 594 (0.9) | <0.001 |
| Acute kidney injury | 3916 (1.1) | 1954 (1.3) | <0.001 | 1486 (0.9) | <0.001 | 918 (1.3) | <0.001 |
| ARDS | 6039 (1.7) | 3262 (2.2) | <0.001 | 2238 (1.4) | <0.001 | 1421 (2.0) | <0.001 |
| Myocardial infarction | 1044 (0.3) | 504 (0.3) | <0.001 | 376 (0.2) | <0.001 | 240 (0.3) | <0.05 |
| Pulmonary embolism | 3188 (0.9) | 1917 (1.3) | <0.001 | 1165 (0.7) | <0.001 | 432 (0.6) | <0.001 |
| Unplanned ICU | 1742 (0.5) | 802 (0.5) | <0.001 | 768 (0.5) | 0.86 | 349 (0.5) | 0.57 |
| Unplanned intubation | 2468 (0.7) | 1152 (0.8) | <0.05 | 1057 (0.7) | 0.14 | 537 (0.8) | <0.05 |
| Osteomyelitis | 177 (0.05) | 59 (0.01) | <0.05 | 115 (0.1) | <0.001 | 24 (0.03) | <0.05 |
| Pneumonia | 11975 (3.3) | 5785 (3.9) | <0.001 | 4783 (3.0) | <0.001 | 2969 (4.3) | <0.001 |
| Mortality, n (%) | 16152 (4.5) | 8889 (6.2) | <0.001 | 4473 (2.9) | <0.001 | 4806 (7.1) | <0.001 |
SD = standard deviation, IQR = interquartile range, LOS = length of stay, ICU = intensive care unit, ARDS = acute respiratory distress syndrome.