Comparable healing, divergent function in tibia diaphyseal fractures stratified by age

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Geriatric Medicine

Background:

• Tibia shaft fractures are common injuries affecting various age groups.
• Optimal treatment and outcomes for elderly patients with these fractures require further investigation.
• Comparing outcomes between younger and older adults is crucial for personalized care.

Purpose of the Study:

• To compare fracture union rates in tibia shaft fractures between patients younger than 65 and those 65 or older.
• To evaluate secondary outcomes including quality of life and functional recovery.
• To identify age-related differences in treatment outcomes for tibia shaft fractures.

Main Methods:

• Retrospective review of patients with isolated OTA 42A-42C tibia shaft fractures treated with intramedullary nails.
• Fracture union assessed by RUST score, and functional outcome by Functional Ambulatory Category (FAC) score.
• Patients categorized into young (<65) and elderly (≥65) groups, with univariate and multivariate analyses.

Main Results:

• No significant difference in union rates (94.0% elderly vs. 89.3% young) or time to union between age groups.
• Similar readmission and complication rates observed between young and elderly patients.
• Older age independently predicted lower FAC scores at 3, 6, and 12 months post-injury.

Conclusions:

• Intramedullary nailing for tibia shaft fractures yields comparable union rates and healing times in elderly and younger patients.
• Elderly patients may experience reduced ambulatory function despite similar fracture healing.
• Age is an independent predictor of functional outcomes in tibia shaft fracture recovery.