Can a combination of different risk factors be correlated with leg fracture healing time?
A multicenter retrospective analysis of patients treated for leg fractures was conducted to develop a score that correlates with fracture healing time and to identify the risk gradient for delayed healing.
Fifty-three patients were analyzed and considered healed when full weight bearing was possible. Patients were divided into those who healed within 180 days and those who took longer to heal. Risk factors associated with delayed healing, fracture morphology, and orthopedic treatments were recorded. The available literature was used to weight the relative risk associated with each factor; values were combined into a score evaluating the risk of delayed healing: L-ARRCO (a literature-based score where the risk of delayed bone healing is calculated using a specific algorithm). Other risk factors associated with delayed healing were then considered in order to calculate a new score, ARRCO. Continuous variables were compared between groups using Student’s heteroschedastic two-tail t test. Receiver operating characteristic (ROC) curves and the areas under the curves were calculated to determine the ability of this score to discriminate subjects with delayed healing.
The mean L-ARRCO scores of the patients who healed within and after 180 days were significantly different (5.78 ± 1.59 and 7.05 ± 2.46, respectively). The mean ARRCO scores of the patients who healed within and after 180 days were also significantly different (5.92 ± 1.78 and 9.03 ± 2.79, respectively). However, the area under the ROC curve was significantly smaller for L-ARRCO than for ARRCO (0.62 ± 0.09 versus 0.82 ± 0.07).
The ARRCO score is significantly associated with fracture healing time and could be used to identify “fractures at risk,” allowing early intervention to stimulate osteogenesis.
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- Can a combination of different risk factors be correlated with leg fracture healing time?
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Journal of Orthopaedics and Traumatology
Volume 14, Issue 1 , pp 51-57
- Cover Date
- Print ISSN
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- Springer Milan
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- Leg fracture
- Delayed healing
- Risk factor score
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- Author Affiliations
- 1. Orthopaedic and Traumatology Department, Sant’Anna Hospital, University of Ferrara, Via Savonarola 9, 44121, Ferrara, Italy
- 2. Orthopaedic and Traumatology Department, S. Spirito in Sassia Hospital, Lungotevere in Sassia 1, 00193, Rome, Italy
- 3. Orthopaedic and Traumatology Department, IRCCS Foundation San Matteo Hospital, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
- 4. II Orthopaedic and Traumatology Clinic, Rizzoli Orthopaedic Institute, University of Bologna, Via Pupilli 1, 40134, Bologna, BO, Italy
- 5. IGEA SpA, Clinical Biophysics, Via Parmenide 10/A, 41012, Carpi, MO, Italy