Clinical Outcomes After Intramedullary Nailing of Intraarticular Distal Tibial Fractures: A Retrospective Review

Metcalf, Kathryn B.; Brown, Corina C.; Barksdale, Edward M.; Wetzel, Robert J.; Sontich, John K.; Ochenjele, George

doi:10.5435/jaaosglobal-d-20-00088

Cited by 3 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tibial shaft fractures are prevalent and have high rates of complications such as infection, nonunion, and reoperation. 2,3,6,7,12 Given this, there has been growing interest in PROMs to measure patient outcomes 9,[13][14][15] and use MCIDs to measure clinical improvement. The purpose of this study was to determine PROMIS PF MCID values for patients with operatively treated tibial fractures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture

Thorne

Kellam

Nelson

et al. 2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

Objective: To calculate the minimal clinically important differences (MCIDs) of patient-reported outcomes measurement information system physical function (PROMIS PF) scores for patients with operatively treated tibial shaft fractures. Design: Retrospective Cohort Study. Setting: A Level 1 trauma center. Patients: All operatively treated tibial shaft fractures identified by Current Procedural Terminology codes. Intervention: Enrolled patients treated acutely with operative fixation of their tibia. Main Outcome Measurements: MCIDs were calculated by distribution-based and anchor-based methods, calculated from PROMIS PF scores completed at least at two-time points postoperatively. MCIDs were calculated at different time points including overall, 7–12 weeks, 3–6 months, and 6–24 months. MCIDs were calculated for different subgroups including open fractures, closed fractures, any complications, and no complications. Results: MCID for PROMIS PF scores was 5.7 in the distribution-based method and 7.84 (SD 18.65) in the anchor-based method. At 6–24 postoperatively, the months the distribution-based MCID was 5.95 from a postoperative baseline 27.83 (8.74) to 42.85 (9.61), P < 0.001. At 6–24 months, the anchor-based MCID was 10.62 with a score difference between the improvement group of 16.03 (10.73) and the no improvement group of 5.41 (15.75), P < 0.001. Patients with open fractures (distribution-based 6.22 and anchor-based 8.05) and any complications (distribution-based 5.71 and anchor-based 9.29) had similar or higher MCIDs depending on the methodology used than the overall cohort MCIDs. Conclusion: This study identified distribution-based MCID of 5.7 and anchor-based MCID of 7.84 calculated from PROMIS PF scores in operative tibial shaft fractures. Distribution-based methods yielded smaller MCIDs than anchor-based methods. These MCID scores provide a standard to compare clinical and investigational outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

“…12 Owing to the prevalence of tibial shaft fractures and the risk for complications, there has been increasing interest in patient-reported outcomes (PRO) in patients with tibial shaft fractures. 9,[13][14][15][16] Measuring PROs provides a basis to assess the effectiveness of treatment and can guide clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture

Thorne

Kellam

Nelson

et al. 2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

show abstract

There are more things in physical function and pain: a systematic review on physical, mental and social health within the orthopedic fracture population using PROMIS

Houwen

Munter

Lansink

et al. 2022

J Patient Rep Outcomes

View full text Add to dashboard Cite

Background The Patient-Reported Outcomes Information System (PROMIS®) is more and more extensively being used in medical literature in patients with an orthopedic fracture. Yet, many articles studied heterogeneous groups with chronic orthopedic disorders in which fracture patients were included as well. At this moment, there is no systematic overview of the exact use of PROMIS measures in the orthopedic fracture population. Therefore this review aimed to provide an overview of the PROMIS health domains physical health, mental health and social health in patients suffering an orthopedic fracture. Methods This systematic review was documented according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. We searched Embase, Medline, Web of Science Core Collection, and Cochrane Central Register of controlled Trials, CINAHL and Google Scholar in December 2020 using a combination of MeSH terms and specific index terms related to orthopedic fractures and PROMIS questionnaires. Inclusion criteria were available full text articles that were describing the use of any PROMIS questionnaires in both the adult and pediatric extremity fracture population. Results We included 51 relevant articles of which most were observational studies (n = 47, 92.2%). A single fracture population was included in 47 studies of which 9 involved ankle fractures (9/51; 17.6%), followed by humeral fractures (8/51; 15.7%), tibia fractures (6/51; 11.8%) and radial -or ulnar fractures (5/51; 9.8%). PROMIS Physical Function (n = 32, 32/51 = 62.7%) and PROMIS Pain Interference (n = 21, 21/51 = 41.2%) were most frequently used questionnaires. PROMIS measures concerning social (n = 5/51 = 9.8%) and mental health (10/51 = 19.6%) were much less often used as outcome measures in the fracture population. A gradually increasing use of PROMIS questionnaires in the orthopedic fracture population was seen since 2017. Conclusion Many different PROMIS measures on multiple domains are available and used in previous articles with orthopedic fracture patients. With physical function and pain interference as most popular PROMIS measures, it is important to emphasize that other health-domains such as mental and social health can also be essential to fracture patients.

show abstract

Impact of Surgical Timing on Fracture Healing in Tibial Shaft Injuries: A Comparative Review of Intramedullary Nailing Techniques

Kashyap,

Ambade,

Landge

et al. 2024

Cureus

View full text Add to dashboard Cite

Tibial shaft fractures are a prevalent and challenging orthopedic injury, often resulting from high-energy trauma. Optimal management of these fractures is crucial to prevent complications such as nonunion, malunion, and prolonged functional impairment. Intramedullary nailing (IMN) is widely regarded as the gold standard for treating these injuries due to its ability to provide stable fixation, preserve soft tissues, and enable early mobilization. However, the timing of surgical intervention remains a topic of ongoing debate. Early surgical intervention, defined as surgery within 24-48 hours of injury, is advocated for its potential to reduce hospital stay, facilitate early mobilization, and decrease the risk of secondary complications such as compartment syndrome. Conversely, delayed intervention allows for patient stabilization and reduction of soft tissue swelling, potentially lowering the risk of infection and other complications. This comprehensive review aims to evaluate the impact of surgical timing on fracture healing outcomes in tibial shaft fractures treated with IMN. It explores the benefits and limitations of early versus delayed surgery, emphasizing their influence on union rates, healing time, and complication rates. Furthermore, the review examines different IMN techniques, including reamed versus unreamed and static versus dynamic nailing, to determine their role in optimizing fracture healing. By synthesizing current evidence, this review provides critical insights into the optimal timing and technique for IMN in tibial shaft fractures, ultimately aiming to guide clinical decision-making and improve patient outcomes. Future research should focus on randomized controlled trials to establish standardized surgical timing and technique selection guidelines in this patient population.

show abstract

Clinical Outcomes After Intramedullary Nailing of Intraarticular Distal Tibial Fractures: A Retrospective Review

Cited by 3 publications

References 22 publications

Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture

Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture

There are more things in physical function and pain: a systematic review on physical, mental and social health within the orthopedic fracture population using PROMIS

Impact of Surgical Timing on Fracture Healing in Tibial Shaft Injuries: A Comparative Review of Intramedullary Nailing Techniques

Contact Info

Product

Resources

About