Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: A randomized controlled trial

S. Sprague; D. Heels-Ansdell; S. Bzovsky; R. Zdero; M. Bhandari; M. Swiontkowski; P. Tornetta; D. Sanders; E. Schemitsch

doi:10.1302/2633-1462.21.BJO-2020-0150.R1

Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: A randomized controlled trial

S. Sprague
, D. Heels-Ansdell
, S. Bzovsky
, R. Zdero
, M. Bhandari
, M. Swiontkowski
, P. Tornetta
, D. Sanders
, E. Schemitsch

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Aims Using tibial shaft fracture participants from a large, multicentre randomized controlled trial, we investigated if patient and surgical factors were associated with health-related quality of life (HRQoL) at one year post-surgery. Methods The Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) trial examined adults with an open or closed tibial shaft fracture who were treated with either reamed or unreamed intramedullary nails. HRQoL was assessed at hospital discharge (for pre-injury level) and at 12 months post-fracture using the Short Musculoskeletal Functional Assessment (SMFA) Dysfunction, SMFA Bother, 36-Item Short Form 36 (SF-36) Physical, and SF-36 Mental Component scores. We used multiple linear regression analysis to determine if baseline and surgical factors, as well as post-intervention procedures within one year of fracture, were associated with these HRQoL outcomes. Significance was set at p < 0.01. We hypothesize that, irrespective of the four measures used, prognosis is guided by both modifiable and non-modifiable factors and that patients do not return to their pre-injury level of function, nor HRQoL. Results For patient and surgical factors, only pre-injury quality of life and isolated fracture showed a statistical effect on all four HRQoL outcomes, while high-energy injury mechanism, smoking, and race or ethnicity, demonstrated statistical significance for three of the four HRQoL outcomes. Patients who did not require reoperation in response to infection, the need for bone grafts, and/or the need for implant exchanges had statistically superior HRQoL outcomes than those who did require intervention within one year after initial tibial fracture nailing. Conclusion We identified several baseline patient factors, surgical factors, and post-intervention procedures within one year after intramedullary nailing of a tibial shaft fracture that may influence a patient's HRQoL.

Original language	English (US)
Pages (from-to)	22-32
Number of pages	11
Journal	Bone and Joint Open
Volume	2
Issue number	1
DOIs	https://doi.org/10.1302/2633-1462.21.BJO-2020-0150.R1
State	Published - Jan 2021
Externally published	Yes

Bibliographical note

Funding Information:
„ This study was partially funded by the Canadian Institutes of Health Research (MCT-38140) and the National Institutes of Health (NIAMS-072; R01 AR48529). Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but will be directed solely to a research fund, foundation, educational institution, or other non-profit organization with which one or more of the authors are associated.

Funding Information:
„ S. Sprague and M. Bhandari declare institutional grants from Zimmer, the Orthopaedic Trauma Association, and an OREF clinical trial grant, related to this study. D. Heels-Andsell declares institutional grants from Zimmer, the Orthopaedic Research and Education Foundation, the Orthopaedic Trauma Association, and a Hamilton Health Sciences research grant, related to this study.

Publisher Copyright:
© 2021 Author(s) et al.

Keywords

Health-related quality of life
Intramedullary nailing
Prognostic
Tibial shaft
Trauma

Publisher link

10.1302/2633-1462.21.BJO-2020-0150.R1

Find It

Find It at U of M Libraries

Cite this

Sprague, S., Heels-Ansdell, D., Bzovsky, S., Zdero, R., Bhandari, M., Swiontkowski, M., Tornetta, P., Sanders, D., & Schemitsch, E. (2021). Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: A randomized controlled trial. Bone and Joint Open, 2(1), 22-32. https://doi.org/10.1302/2633-1462.21.BJO-2020-0150.R1

Sprague, S, Heels-Ansdell, D, Bzovsky, S, Zdero, R, Bhandari, M, Swiontkowski, M, Tornetta, P, Sanders, D & Schemitsch, E 2021, 'Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: A randomized controlled trial', Bone and Joint Open, vol. 2, no. 1, pp. 22-32. https://doi.org/10.1302/2633-1462.21.BJO-2020-0150.R1

@article{5ed1a5a494ae4ecca86080b43356a5cb,

title = "Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: A randomized controlled trial",

abstract = "Aims Using tibial shaft fracture participants from a large, multicentre randomized controlled trial, we investigated if patient and surgical factors were associated with health-related quality of life (HRQoL) at one year post-surgery. Methods The Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) trial examined adults with an open or closed tibial shaft fracture who were treated with either reamed or unreamed intramedullary nails. HRQoL was assessed at hospital discharge (for pre-injury level) and at 12 months post-fracture using the Short Musculoskeletal Functional Assessment (SMFA) Dysfunction, SMFA Bother, 36-Item Short Form 36 (SF-36) Physical, and SF-36 Mental Component scores. We used multiple linear regression analysis to determine if baseline and surgical factors, as well as post-intervention procedures within one year of fracture, were associated with these HRQoL outcomes. Significance was set at p < 0.01. We hypothesize that, irrespective of the four measures used, prognosis is guided by both modifiable and non-modifiable factors and that patients do not return to their pre-injury level of function, nor HRQoL. Results For patient and surgical factors, only pre-injury quality of life and isolated fracture showed a statistical effect on all four HRQoL outcomes, while high-energy injury mechanism, smoking, and race or ethnicity, demonstrated statistical significance for three of the four HRQoL outcomes. Patients who did not require reoperation in response to infection, the need for bone grafts, and/or the need for implant exchanges had statistically superior HRQoL outcomes than those who did require intervention within one year after initial tibial fracture nailing. Conclusion We identified several baseline patient factors, surgical factors, and post-intervention procedures within one year after intramedullary nailing of a tibial shaft fracture that may influence a patient's HRQoL.",

keywords = "Health-related quality of life, Intramedullary nailing, Prognostic, Tibial shaft, Trauma",

author = "S. Sprague and D. Heels-Ansdell and S. Bzovsky and R. Zdero and M. Bhandari and M. Swiontkowski and P. Tornetta and D. Sanders and E. Schemitsch",

note = "Funding Information: „ This study was partially funded by the Canadian Institutes of Health Research (MCT-38140) and the National Institutes of Health (NIAMS-072; R01 AR48529). Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but will be directed solely to a research fund, foundation, educational institution, or other non-profit organization with which one or more of the authors are associated. Funding Information: „ S. Sprague and M. Bhandari declare institutional grants from Zimmer, the Orthopaedic Trauma Association, and an OREF clinical trial grant, related to this study. D. Heels-Andsell declares institutional grants from Zimmer, the Orthopaedic Research and Education Foundation, the Orthopaedic Trauma Association, and a Hamilton Health Sciences research grant, related to this study. Publisher Copyright: {\textcopyright} 2021 Author(s) et al.",

year = "2021",

month = jan,

doi = "10.1302/2633-1462.21.BJO-2020-0150.R1",

language = "English (US)",

volume = "2",

pages = "22--32",

journal = "Bone and Joint Open",

issn = "2633-1462",

publisher = "British Editorial Society of Bone and Joint Surgery",

number = "1",

}

TY - JOUR

T1 - Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures

T2 - A randomized controlled trial

AU - Sprague, S.

AU - Heels-Ansdell, D.

AU - Bzovsky, S.

AU - Zdero, R.

AU - Bhandari, M.

AU - Swiontkowski, M.

AU - Tornetta, P.

AU - Sanders, D.

AU - Schemitsch, E.

N1 - Funding Information: „ This study was partially funded by the Canadian Institutes of Health Research (MCT-38140) and the National Institutes of Health (NIAMS-072; R01 AR48529). Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but will be directed solely to a research fund, foundation, educational institution, or other non-profit organization with which one or more of the authors are associated. Funding Information: „ S. Sprague and M. Bhandari declare institutional grants from Zimmer, the Orthopaedic Trauma Association, and an OREF clinical trial grant, related to this study. D. Heels-Andsell declares institutional grants from Zimmer, the Orthopaedic Research and Education Foundation, the Orthopaedic Trauma Association, and a Hamilton Health Sciences research grant, related to this study. Publisher Copyright: © 2021 Author(s) et al.

PY - 2021/1

Y1 - 2021/1

N2 - Aims Using tibial shaft fracture participants from a large, multicentre randomized controlled trial, we investigated if patient and surgical factors were associated with health-related quality of life (HRQoL) at one year post-surgery. Methods The Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) trial examined adults with an open or closed tibial shaft fracture who were treated with either reamed or unreamed intramedullary nails. HRQoL was assessed at hospital discharge (for pre-injury level) and at 12 months post-fracture using the Short Musculoskeletal Functional Assessment (SMFA) Dysfunction, SMFA Bother, 36-Item Short Form 36 (SF-36) Physical, and SF-36 Mental Component scores. We used multiple linear regression analysis to determine if baseline and surgical factors, as well as post-intervention procedures within one year of fracture, were associated with these HRQoL outcomes. Significance was set at p < 0.01. We hypothesize that, irrespective of the four measures used, prognosis is guided by both modifiable and non-modifiable factors and that patients do not return to their pre-injury level of function, nor HRQoL. Results For patient and surgical factors, only pre-injury quality of life and isolated fracture showed a statistical effect on all four HRQoL outcomes, while high-energy injury mechanism, smoking, and race or ethnicity, demonstrated statistical significance for three of the four HRQoL outcomes. Patients who did not require reoperation in response to infection, the need for bone grafts, and/or the need for implant exchanges had statistically superior HRQoL outcomes than those who did require intervention within one year after initial tibial fracture nailing. Conclusion We identified several baseline patient factors, surgical factors, and post-intervention procedures within one year after intramedullary nailing of a tibial shaft fracture that may influence a patient's HRQoL.

AB - Aims Using tibial shaft fracture participants from a large, multicentre randomized controlled trial, we investigated if patient and surgical factors were associated with health-related quality of life (HRQoL) at one year post-surgery. Methods The Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) trial examined adults with an open or closed tibial shaft fracture who were treated with either reamed or unreamed intramedullary nails. HRQoL was assessed at hospital discharge (for pre-injury level) and at 12 months post-fracture using the Short Musculoskeletal Functional Assessment (SMFA) Dysfunction, SMFA Bother, 36-Item Short Form 36 (SF-36) Physical, and SF-36 Mental Component scores. We used multiple linear regression analysis to determine if baseline and surgical factors, as well as post-intervention procedures within one year of fracture, were associated with these HRQoL outcomes. Significance was set at p < 0.01. We hypothesize that, irrespective of the four measures used, prognosis is guided by both modifiable and non-modifiable factors and that patients do not return to their pre-injury level of function, nor HRQoL. Results For patient and surgical factors, only pre-injury quality of life and isolated fracture showed a statistical effect on all four HRQoL outcomes, while high-energy injury mechanism, smoking, and race or ethnicity, demonstrated statistical significance for three of the four HRQoL outcomes. Patients who did not require reoperation in response to infection, the need for bone grafts, and/or the need for implant exchanges had statistically superior HRQoL outcomes than those who did require intervention within one year after initial tibial fracture nailing. Conclusion We identified several baseline patient factors, surgical factors, and post-intervention procedures within one year after intramedullary nailing of a tibial shaft fracture that may influence a patient's HRQoL.

KW - Health-related quality of life

KW - Intramedullary nailing

KW - Prognostic

KW - Tibial shaft

KW - Trauma

UR - https://www.scopus.com/pages/publications/85127369924

UR - https://www.scopus.com/pages/publications/85127369924#tab=citedBy

U2 - 10.1302/2633-1462.21.BJO-2020-0150.R1

DO - 10.1302/2633-1462.21.BJO-2020-0150.R1

M3 - Article

C2 - 33537673

AN - SCOPUS:85127369924

SN - 2633-1462

VL - 2

SP - 22

EP - 32

JO - Bone and Joint Open

JF - Bone and Joint Open

IS - 1

ER -

Prognostic factors for predicting health-related quality of life after intramedullary nailing of tibial fractures: A randomized controlled trial

Abstract

Bibliographical note

Keywords

Publisher link

Find It

Other files and links

Fingerprint

Cite this