One-year outcome after tibial shaft fractures: results of a prospective fracture registry.

OBJECTIVES

To describe the outcome in a consecutive series of patients with tibial shaft fractures and to determine whether prospective registration of fracture care produces useful data for clinical purposes.

DESIGN

A prospective follow-up study.

SETTING

A large teaching hospital in Stockholm, Sweden.

PATIENTS

Sixty-four consecutive patients with a tibial shaft fracture.

INTERVENTION

Patients were surgically treated according to the protocols at our institute and were followed up prospectively for one year.

MAIN OUTCOME MEASUREMENTS

Clinical outcome, functional results, Short Form 36 Health Survey, Olerud Molander Ankle score, visual analogue scale.

RESULTS

The fractures were classified as 42A (61 percent), 42B (31 percent), and 42C (8 percent). Forty-three (67 percent) patients were treated with an interlocked tibial nail. The complication rate was low and associated with high-energy trauma. The quality of life according to the Short Form 36 Health Survey was diminished at four and twelve months after the injury, as compared with the preinjury status. Twelve months after the injury, 44 percent had not regained full function of the injured leg, although all but two of the patients had returned to preinjury working status.

CONCLUSIONS

Although the complication rate was low, twelve months after the injury, nearly half the patients still experienced functional limitations related to the fracture, which was also reflected in the quality-of-life parameters. There were difficulties in retrieving data for this registry. We think that periodic, rather than continuous, registration of patient-related outcome after fracture treatment is more beneficial from a clinical and economic point of view.