Bone and Joint Institute
Document Type
Conference Proceeding
Publication Date
3-1-2016
Journal
Journal of Orthopaedic Trauma
Volume
30
Issue
3
First Page
142
Last Page
148
URL with Digital Object Identifier
10.1097/BOT.0000000000000497
Abstract
© Copyright 2015 Wolters Kluwer Health, Inc. All rights reserved. Objectives: We sought to determine the effect of reaming on 1-year 36-item short-form general health survey (SF-36) and short musculoskeletal function assessment (SMFA) scores from the Study to Prospectively Evaluate Reamed Intramedullary Nails in patients with Tibial Fractures. Design: Prospective randomized controlled trial.1319 patients were randomized to reamed or unreamed nails. Fractures were categorized as open or closed. Setting: Twenty-nine academic and community health centers across the US, Canada, and the Netherlands. Patients/Participants: One thousand three hundred and nineteen skeletally mature patients with closed and open diaphyseal tibia fractures. Intervention: Reamed versus unreamed tibial nails. Main Outcome Measurements: SF-36 and the SMFA. Outcomes were obtained during the initial hospitalization to reflect preinjury status, and again at the 2-week, 3-month, 6-month, and 1-year follow-up. Repeated measures analyses were performed with P < 0.05 considered significant. Results: There were no differences between the reamed and unreamed groups at 12 months for either the SF-36 physical component score [42.9 vs. 43.4, P 0.54, 95% Confidence Interval for the difference (CI) -2.1 to 1.1] or the SMFA dysfunction index (18.0 vs. 17.6, P 0.79. 95% CI, -2.2 to 2.9). At one year, functional outcomes were significantly below baseline for the SF-36 physical componentf score, SMFA dysfunction index, and SMFA bothersome index (P < 0.001). Time and fracture type were significantly associated with functional outcome. Conclusions: Reaming does not affect functional outcomes after intramedullary nailing for tibial shaft fractures. Patients with open fractures have worse functional outcomes than those with a closed injury. Patients do not reach their baseline function by 1 year after surgery.
Notes
This is an author accepted manuscript.
Published in final edited form as: Lin. C. A., Swiontkowski, M., Bhandari, M., Walter, S. D., Schemitsch, E. H., Sanders, D., & Tornetta P. (2016). Reaming Does Not Affect Functional Outcomes after Open and Closed Tibial Shaft Fractures: The Results of a Randomized Controlled Trial. J Orthop Trauma, 30 (3): 142–148. doi:10.1097/BOT.0000000000000497
Note that erratum was published for this article.