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Outcome at 1 year in patients with femoral shaft fractures treated with intramedullary nailing or skeletal traction in a low-income country: a prospective observational study of 187 patients in Malawi
- Source :
- Acta Orthopaedica, Vol 91, Iss 6, Pp 724-731 (2020)
- Publication Year :
- 2020
- Publisher :
- Medical Journals Sweden, 2020.
-
Abstract
- Background and purpose — Intramedullary nailing (IMN) is underutilized in low-income countries (LICs) where skeletal traction (ST) remains the standard of care for femoral shaft fractures. This prospective study compared patient-reported quality of life and functional status after femoral shaft fractures treated with IMN or ST in Malawi. Patients and methods — Adult patients with femoral shaft fractures managed by IMN or ST were enrolled prospectively from 6 hospitals. Quality of life and functional status were assessed using EQ-5D-3L, and the Short Musculoskeletal Function Assessment (SMFA) respectively. Patients were followed up at 6 weeks, 3, 6, and 12 months post-injury. Results — Of 248 patients enrolled (85 IMN, 163 ST), 187 (75%) completed 1-year follow-up (55 IMN, 132 ST). 1 of 55 IMN cases had nonunion compared with 40 of 132 ST cases that failed treatment and converted to IMN (p < 0.001). Quality of life and SMFA Functional Index Scores were better for IMN than ST at 6 weeks, 3 and 6 months, but not at 1 year. At 6 months, 24 of 51 patients in the ST group had returned to work, compared with 26 of 37 in the IMN group (p = 0.02). Interpretation — Treatment with IMN improved early quality of life and function and allowed patients to return to work earlier compared with treatment with ST. Approximately one-third of patients treated with ST failed treatment and were converted to IMN.
- Subjects :
- Orthopedic surgery
RD701-811
Subjects
Details
- Language :
- English
- ISSN :
- 17453674, 17453682, and 47198753
- Volume :
- 91
- Issue :
- 6
- Database :
- Directory of Open Access Journals
- Journal :
- Acta Orthopaedica
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.57d947c7cde471987534090648cf151
- Document Type :
- article
- Full Text :
- https://doi.org/10.1080/17453674.2020.1794430