Characteristics of patients, fractures, treatment and follow-up, secondary interventions and complications, by amount of initial fracture shortening (< 20 mm v. ≥ 20 mm) (n = 224)
| Characteristic | Amount of initial fracture shortening; no. (%) of cases* | p value | |
|---|---|---|---|
| < 20 mm n = 157 | ≥ 20 mm n = 67 | ||
| Patients | |||
| Sex | 0.6 | ||
| Female | 39 (24.8) | 14 (20.9) | |
| Male | 118 (75.2) | 53 (79.1) | |
| Age, mean ± SD, yr | 1.90 ± 1.18 | 3.07 ± 1.33 | 0.006 |
| Weight, mean ± SD, kg | 13.57 ± 3.05 | 16.54 ± 3.14 | < 0.001 |
| Fractures | |||
| Fracture pattern | 0.3 | ||
| Spiral | 93 (59.2) | 44 (65.7) | |
| Oblique | 41 (26.1) | 18 (26.9) | |
| Transverse | 22 (14.0) | 4 (6.0) | |
| Comminuted | 1 (0.6) | 1 (1.5) | |
| Initial shortening, mean ± SD, mm | 9.9 ± 6.8 | 26.4 ± 5.9 | — |
| Initial coronal angulation, mean ± SD, ° | 10.6 ± 10.1 | 11.6 ± 8.3 | 0.5 |
| Initial angulation sagittal, mean ± SD, ° | 10.6 ± 11 | 9.8 ± 8.7 | 0.6 |
| Treatment | |||
| Delay between injury and spica application, mean ± SD, d | 0.99 ± 0.58 | 0.97 ± 0.52 | — |
| Type of spica | 0.6 | ||
| Single leg | 112 (71.3) | 45 (67.2) | |
| One and a half legs | 37 (23.6) | 21 (31.3) | |
| Two legs | 4 (2.5) | 1 (1.5) | |
| Unknown | 4 (2.5) | 0 (0.0) | |
| Orthopedic technician present | 0.07 | ||
| Yes | 99 (63.1) | 33 (49.2) | |
| No | 57 (36.3) | 34 (50.7) | |
| Missing | 1 (0.6) | 0 (0.0) | |
| Length of total hospital stay, mean ± SD, d | 1.59 ± 0.93 | 1.64 ± 1.08 | 0.7 |
| Follow-up | |||
| Time with spica, mean ± SD, d | 35.45 ± 7.66 | 39.24 ± 9.6 | 0.002 |
| Duration of follow-up, mean ± SD, mo | 6.74 ± 9.73 | 8.88 ± 11.61 | 0.2 |
| No. of follow-up visits, mean ± SD | 3.18 ± 1.24 | 3.63 ± 1.35 | 0.02 |
| Radiographic shortening at last follow-up, mean ± SD, mm | 4.0 ± 4.9 | 10.2 ± 5.8 | < 0.001 |
| Radiographic coronal angulation at last follow-up, mean ± SD, ° | 3.9 ± 4.7 | 4.8 ± 4.5 | 0.2 |
| Radiographic sagittal angulation at last follow-up, mean ± SD, ° | 9.7 ± 9.3 | 7.3 ± 5.1 | 0.07 |
| Secondary interventions and complications | |||
| Concurrent intervention | 0.8 | ||
| Cast wedging | 5 (3.2) | 2 (3.0) | |
| Cast change | 1 (0.6) | 0 (0.0) | |
| Early secondary intervention | — | ||
| Cast wedging | 2 (1.3) | 3 (4.5) | |
| Cast change and flexible intramedullary nailing | 0 (0.0) | 1 (1.5) | |
| Early complications | 0.4 | ||
| Skin issues | 7 (4.5) | 2 (3.0) | |
| Cast breakage | 0 (0.0) | 1 (1.5) | |
| Clinically measurable LLD | 26 (16.6) | 20 (29.8) | 0.04 |
| Clinically measurable valgus deformity | 0 (0.0) | 1 (1.5) | 0.7 |
LLD = limb length discrepancy; SD = standard deviation.
↵* Except where noted otherwise.