No Difference in Short-Term Complications following Treatment of Closed Tibial Shaft Fractures with Intramedullary Nailing versus Plate Fixation
Table 1
Demographic and comorbidity characteristics for patients undergoing tibial ORIF and IMN.
IMN unadjusted (%)
ORIF (%)
value
IMN matched (%)
ORIF (%)
value
Patients, N (%)
2136 (77.5)
621 (22.5)
621 (50)
621 (50)
Age (years, mean ± SD)
31.1 ± 18.5
36.8 ± 18.4
<0.001
37.1 ± 19.6
36.8 ± 18.4
0.766
BMI (kg/m2, mean ± SD)
27.8 ± 7.1
29.2 ± 7.6
<0.001
28.9 ± 7.3
29.2 ± 7.6
0.358
Male sex
1174 (55.0)
272 (43.8)
<0.001
284 (45.7)
272 (43.8)
0.530
Operative time (mins)
99.1 ± 51.7
100.0 ± 47.5
0.660
98.5 ± 55.1
100.0 ± 47.5
0.601
Length of stay
3.55 ± 4.04
3.32 ± 5.76
0.366
3.71 ± 3.66
3.32 ± 5.76
0.160
ASA class
2.18 ± 0.8
2.27 ± 0.78
0.016
2.23 ± 0.77
2.27 ± 0.78
0.381
1 (no disturbance)
426 (19.9)
103 (16.6)
—
113 (18.2)
103 (16.6)
—
2 (mild disturbance)
971 (45.5)
268 (43.2)
—
266 (42.8)
268 (43.2)
—
3 (severe disturbance)
652 (30.5)
228 (36.7)
—
225 (36.2)
228 (36.7)
—
4 (life-threatening disturbance)
87 (4.1)
21 (3.4)
—
17 (2.7)
21 (3.4)
—
5 (moribund)
0
1 (0.2)
—
0
1 (0.2)
—
Race
White
1445 (67.6)
423 (68.9)
—
423 (68.9)
423 (68.9)
—
Black
199 (9.3)
57 (9.2)
—
57 (9.2)
57 (9.2)
—
Asian
69 (3.2)
16 (2.3)
—
16 (2.3)
16 (2.3)
—
Other
423 (19.8)
125 (20.1)
—
125 (20.1)
125 (20.1)
—
Dependent functional status (partial or total)
143 (6.7)
48 (7.7)
0.413
48 (7.7)
48 (7.7)
0.439
Current smoker
611 (28.6)
143 (23.0)
0.006∗
145 (23.3)
143 (23.0)
0.944
Comorbidities, N (%)
Congestive heart failure
17 (0.80)
7 (1.1)
0.456
6 (0.97)
7 (1.1)
1
Renal failure
9 (0.42)
2 (0.32)
1
4 (0.64)
2 (0.32)
0.701
Dialysis
26 (1.2)
7 (1.1)
1
4 (0.64)
7 (1.1)
0.568
Steroid use
55 (2.6)
17 (2.7)
0.874
19 (3.1)
17 (2.7)
0.857
Weight loss
5 (0.23)
2 (0.32)
1
4 (0.64)
2 (0.32)
0.693
Bleeding disorder
107 (5.0)
29 (4.7)
0.761
35 (5.6)
29 (4.7)
0.526
Ascites
0
0
1
0
0
1
Preoperative transfusion
22 (1.0)
5 (0.81)
0.666
11 (1.8)
5 (0.81)
0.202
Diabetes
271 (12.7)
103 (16.6)
0.010
86 (13.8)
103 (16.6)
0.196
IDDM
153 (7.2)
54 (8.7)
—
52 (8.4)
54 (8.7)
—
NIDDM
118 (5.5)
49 (7.9)
—
34 (5.4)
49 (7.9)
—
DOE
60 (2.8)
26 (4.2)
0.895
17 (2.7)
26 (4.2)
0.226
COPD
90 (4.2)
24 (3.9)
0.787
25 (4.0)
24 (3.9)
1
BMI: body mass index; COPD: chronic obstructive pulmonary disease; DOE: dyspnea on exertion; renal failure: wherein renal function has been compromised within 24 hrs prior to surgery; dialysis: acute or chronic renal failure requiring dialysis within 2 weeks of indexed procedure; weight loss: considered as greater than 10% decrease in body weight in six-month interval preceding surgery; IDDM: insulin-dependent diabetes mellitus.
