Table IV.
36-Item Short Form Physical Component Score (n = 715).
| Factors | Mean difference (95% CI) | p-value |
|---|---|---|
| Phase I - Reduced model | ||
| Patient factors | ||
| Pre-injury QoL score (10-point increase) | -3.47 (-4.32 to -2.62) | < 0.001 |
| Age (10 yr increase) | -1.00 (-1.52 to -0.49) | < 0.001 |
| Male vs female | N/A | N/A |
| Race | 0.003 | |
| Black vs White | -1.94 (-5.17 to 1.29) | |
| Other* vs White | -4.16 (-6.66 to -1.66) | |
| Current smoker vs not | -3.47 (-5.08 to -1.85) | < 0.001 |
| Fracture factors | ||
| Mechanism of injury | ||
| High-energy vs low-energy† | -2.44 (-4.15 to -0.73) | 0.005 |
| Bilateral vs unilateral | N/A | N/A |
| Reamed vs non-reamed nail | ||
| Open | -2.53 (-5.23 to 0.17) | 0.07 |
| Closed | -0.40 (-2.15 to 1.35) | 0.66 |
| Open vs closed | ||
| Reamed | -5.39 (-7.67 to -3.11) | < 0.001 |
| Non-reamed | -3.26 (-5.59 to -0.92) | 0.006 |
| Additional injuries vs isolated fracture | -3.72 (-5.42 to -2.01) | < 0.001 |
| AO/OTA fracture class | ||
| B vs A | N/A | N/A |
| C vs A | N/A | N/A |
| Location of fracture | ||
| Proximal and proximal-middle vs middle | N/A | N/A |
| Distal and distal-middle vs middle | N/A | N/A |
| Treatment factors | ||
| Anticoagulants use vs none | N/A | N/A |
| NSAIDs use vs none | N/A | N/A |
| Surgical factors | ||
| Resident vs surgeon (including fellow)‡ | -2.03 (-3.54 to -0.51) | 0.009 |
| Nail material | ||
| Titanium vs stainless steel | N/A | N/A |
| No. of locking screws | ||
| ≥ 2 on both sides vs < 2 on at least one side | N/A | N/A |
| Tendon split vs tendon retraction | N/A | N/A |
| Portal | ||
| Inferior vs Superior | N/A | N/A |
| Fracture gap – adjudicated | ||
| Gap ≥ 1 cm vs no gap | N/A | N/A |
| Gap < 1 cm vs no gap | N/A | N/A |
| Time from injury to surgery | ||
| Late vs early | N/A | N/A |
| Mid vs early | N/A | N/A |
| Fasciotomy at initial surgery vs none | ||
| Postoperative weight-bearing status | N/A | N/A |
| Full vs partial or non-weightbearing | 2.24 (-0.22 to 4.71) | 0.07 |
| Phase II – Post-intervention model§ | ||
| Reoperations in response to infection | ||
| Late vs none¶ | -8.14 (-15.65 to -0.64) | 0.017 |
| Early vs none | -4.78 (-9.41 to -0.15) | |
| Fasciotomy | ||
| Early vs none | 0.29 (-4.67 to 5.25) | 0.908 |
| Bone graft or implant exchange | 0.005 | |
| Late vs none | -7.98 (-14.27 to -1.68) | |
| Early vs none | -6.31 (-11.99 to -0.62) | |
| Nonoperatively treated infection | ||
| Early vs none | 3.11 (-3.28 to 9.49) | 0.340 |
| Dynamization | 0.031 | |
| Late vs none | -5.47 (-11.66 to 0.72) | |
| Early vs none | -2.70 (-5.25 to -0.14) | |
Other includes all ethnicities except for Black and White.
High-energy includes motor vehicle accident, crush injury, blunt direct trauma. Low-energy includes fall, twist, penetrating direct trauma.
Resident becomes MD -1.59 (95% CI -3.47 to 0.28); p = 0.096 when centre is included in the model as a covariate.
The Phase II model included the baseline predictor variables from the reduced model as covariates. Phase II models also include the following covariates for adjustment: open, reamed, interaction of open with reamed, baseline SF-36 PCS, age, race, mechanism of injury, smoking status, isolated fracture, resident, weight-bearing status.
Early is defined as prior to eight months from initial surgery and late is defined as eight months up to one year.
N/A, not applicable; NSAIDs, non-steroidal anti-inflammatory drugs; QoL, quality of life.