Treatment and re-operation rates in one thousand and three hundred tibial fractures from the Swedish Fracture Register

Abstract

Purpose Approximately, 50 persons per 100,000 per year sustain a tibial fracture. There is, however, a lack of large cohort studies that describe the treatment and re-operation frequencies of tibial fractures. The aim of this study was to describe the treatment and re-operation rates of tibial fractures in all segments of the tibia. Methods Data related to all patients aged 16 and above treated for tibial fractures (ICD-10 S82.10-31) at Sahlgrenska University Hospital in 2011–2015 were extracted from the Swedish Fracture Register. To make sure all re-operations were included in the study, the operation planning system was checked for all patients included in the study. Results The study comprised 1371 tibial fractures − 712 proximal, 417 diaphyseal and 242 distal tibial fractures. Among the proximal and distal tibial fractures, plate fixation was the most commonly used surgical method, whereas among tibial shaft fractures, an intramedullary nail was the most commonly used surgical method. Almost 30% (29.8%) of all surgically treated tibial fractures underwent re-operation. Among proximal tibial fractures, 24.0% underwent re-operation; tibial shaft fractures 37.0% and distal tibial fractures 26.8%. Re-operations due to infection were more or less equally common in all segments (3.9–5.4%). Conclusion This study describes the treatment and re-operation rates after tibial fractures in a cohort of 1371 tibial fractures at Sahlgrenska University Hospital during a period of 5 years. The study shows an overall re-operation rate of 29.8% for fractures in all segments of the tibia.

No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures

“…This assumption is supported by the higher rate of patient-requested reoperations we found in patients ≤ 59 years old. Similar findings have been demonstrated for other surgically treated fractures (Wennergren et al 2021 ). Elderly patients are generally reluctant to undergo additional surgery and probably more inclined to accept dysfunction.…”

“…High validity for reoperations is a proven difficulty in register-based studies and underreporting leads to an underestimation of the risk of reoperation (Wennergren et al 2021 ). To avoid reoperations not registered in the SFR remaining undetected, only patients primarily treated and eligible for follow-up at SUH were included.…”

Risk of total knee replacement after proximal tibia fracture: a register-based study of 7,841 patients

“…Comparison of operative with nonoperative treatment showed that the risk of TKRS increased in the operative group during the first 2 years and thereafter remained about double. Multi-fragmentary fractures have previously been reported as risk factors for reoperations after TPF ( 16 ). In our study, it is likely that the patients in the operative group sustained more displaced and more multi-fragmentary fractures than the patients in the nonoperative treatment group due to high-energy trauma in the younger patients or poor (osteoporotic) bone quality in the older patients.…”

The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register

“…First, the reoperation rate is dependent on accurate registrations of performed re-operations. This process, with its strengths and limitations, has been validated in defined cohorts [ 8 , 9 ].…”

“…The next reasonable step was to conduct descriptive studies of the epidemiology, incidence and mortality of different fractures [ 22 – 26 , 36 – 40 ]. Studies designed to evaluate outcome after the treatment of fractures have been conducted and many are ongoing [ 8 , 9 , 41 , 42 ]. Most publications have focused on the validation of essential features in the SFR or have been descriptive, basic epidemiological studies, as was the intention described above.…”