Table 1 Characteristics of Patients with Internal fixation breakage
From: Are there too many screw holes in plates for fracture fixation?
Issues | Interval between internal fixation and implant breakage, months (M (QR)) | n(%) | χ 2 value | P value |
|---|---|---|---|---|
Patients characteristics | ||||
Age (years) | 5.212 | 0.634 | ||
0–10 | 6.0 | 3(1.8) | ||
11–20 | 6.0(9.0) | 9(5.4) | ||
21–30 | 8.0(11.2) | 32(19.0) | ||
31–40 | 9.0(21.3) | 44(26.2) | ||
41–50 | 10.0(8.0) | 29(17.3) | ||
51–60 | 10.5(16.2) | 22(13.1) | ||
60–69 | 9.0(14.0) | 23(13.7) | ||
70+ | 8.5(21.2) | 6(3.6) | ||
Gender | 0.008 | 0.927 | ||
Male | 9.0(12.5) | 121(72.0) | ||
Female | 9.0(14.0) | 47(28.0) | ||
Body Mass Index (BMI kg/cm2) | 5.398 | 0.249 | ||
< 18.5 | 10.0 | 1(0.6) | ||
18.5–23.9 | 6.5(11.0) | 56(33.3) | ||
24.0–27.9 | 9.0(8.5) | 56(33.3) | ||
28–30 | 10.0(17.0) | 39(23.2) | ||
≥ 30 | 10.8(8.3) | 16(9.5) | ||
Residence | 2.043 | 0.153 | ||
Urban | 7.0(9.0) | 36(21.4) | ||
Rural | 9.0(12.8) | 132(78.6) | ||
Osteoporosis | 0.746 | 0.388 | ||
None | 9.0(12.0) | 149(88.7) | ||
Yes | 9.0(16.0) | 19(11.3) | ||
ASA classification | 2.444 | 0.486 | ||
1 | 8.0(8.0) | 17(10.1) | ||
2 | 9.0(13.5) | 133(79.2) | ||
3 | 8.0(17.0) | 15(8.9) | ||
4 | 10.0(4.0) | 3(1.8) | ||
Medical comorbidities | 6.829 | 0.145 | ||
None | 9.0(13.0) | 141(83.9) | ||
Diabetes | 6.0(6.0) | 9(5.4) | ||
Hypertension | 11.0(11.0) | 10(6.0) | ||
Cardiovascular system disease | 4.0(7.0) | 7(4.2) | ||
Others* | 5.0 | 1(0.6) | ||
Fracture characteristics | ||||
Fracture pattern | 3.012 | 0.390 | ||
Comminuted fracture(s) | 9.3(14.0) | 70(41.7) | ||
Wedge fracture(s) | 6.0(8.5) | 78(46.4) | ||
Oblique fracture(s) | 14.0(23.0) | 13(7.7) | ||
Transverse fracture(s) | 10.0(26.0) | 7(4.2) | ||
AO/OTA classification | 0.103 | 0.950 | ||
Type A | 9.0(13.5) | 46(27.4) | ||
Type B | 9.0(10.0) | 88(52.4) | ||
Type C | 8.5(14.3) | 34(20.2) | ||
Fractured bones | 3.288 | 0.511 | ||
Humerus | 9.5(18.7) | 16(9.5) | ||
Radius/ulna | 10.0(8.0) | 15(8.9) | ||
Femur | 9.0(14.0) | 87(51.8) | ||
Tibia/fibula | 9.0(11.0) | 37(22.0) | ||
Others (Hand, foot and clavicle) | 6.0(10.0) | 13(7.7) | ||
Weight/not weight limbs | 14.466 | <0.001* | ||
Lower limb (Weight bearing bones) | 7.0(7.0) | 133(79.2) | ||
Upper limb (Non-weighted bearing bones) | 18.0(18.0) | 35(20.8) | ||
The side of fracture limbs | 0.182 | 0.670 | ||
Left | 9.0(13.0) | 92(54.8) | ||
Right | 9.5(13.0) | 76(45.2) | ||
Seasonality | 1.490 | 0.685 | ||
Spring | 10.5(19.0) | 46(27.4) | ||
Summer | 9.5(9.0) | 40(23.8) | ||
Autumn | 7.0(9.7) | 37(22.0) | ||
Winter | 9.0(14.0) | 45(26.8) | ||
Open/closed fracture | 0.016 | 0.899 | ||
Open fracture | 8.5(13.2) | 26(15.5) | ||
Closed fracture | 9.0(13.3) | 142(84.5) | ||
Mechanism of injury | 3.600 | 0.463 | ||
Motor vehicle accident | 9.0(13.0) | 99(58.9) | ||
Pedestrian fall | 8.5(10.9) | 44(26.2) | ||
Crush | 11.5(21.8) | 8(4.8) | ||
Fall from height | 11.0(10.1) | 14(8.3) | ||
Sport accident | 6.0(7.0) | 3(1.8) | ||
Number of fracture(s) | 2.031 | 0.362 | ||
1 | 9.0(12.5) | 145(86.3) | ||
2 | 6.0(14.5) | 14(8.3) | ||
> 2 | 6.0(10.5) | 9(5.4) | ||
Operation related issues | ||||
Number of used plates | 1.560 | 0.212 | ||
1 | 12.6(13.0) | 159(94.6) | ||
2 | 17.4(25.0) | 9(5.4) | ||
The shape of used plates | 0.961 | 0.916 | ||
Straight | 9.0(13.3) | 150(89.3) | ||
L-shape | 9.0(7.7) | 8(4.8) | ||
T-shape | 6.0(17.0) | 7(4.2) | ||
Y-shape | 24.0 | 1(0.6) | ||
O-shape | 11.0 | 2(1.2) | ||
Ancillary fixation | 0.427 | 0.935 | ||
None | 9.0(10.0) | 106(63.1) | ||
K-wire(s) | 11.0(14.0) | 19(11.3) | ||
Screw(s) | 9.0(14.0) | 42(25.0) | ||
K-wire(s) and Screw(s) | 8.0 | 1(0.6) | ||
Number of ancillary K-wire(s) | 0.071 | 0.965 | ||
0 | 9.0(13.0) | 149(88.7) | ||
1 | 8.5(11.5) | 8(4.8) | ||
> 1 | 11.0(14.0) | 11(6.5) | ||
Number of ancillary screw(s) | 7.751 | 0.054 | ||
0 | 9.0(10.0) | 126(75.0) | ||
1 | 8.0(6.8) | 20(11.9) | ||
2 | 9.0(24.0) | 11(6.5) | ||
> 2 | 19.0(21.0) | 11(6.5) | ||
Inserting screws closely adjacent to the fracture line | 5.674 | 0.017* | ||
None | 9.0(13.0) | 146(86.9) | ||
Yes | 5.5(8.3) | 22(13.1) | ||
Number of empty screw holes adjacent to the fracture line | 6.245 | 0.182 | ||
0 | 5.5(8.3) | 22(13.1) | ||
1 | 10.0(13.0) | 76(45.2) | ||
2 | 8.5(16.3) | 40(23.8) | ||
3 | 9.0(8.8) | 22(13.1) | ||
> 4 | 9.0(19.5) | 8(4.8) | ||
The type of used plate | 0.122 | 0.727 | ||
Plate(s) | 9.5(10.5) | 71(42.3) | ||
Locked plate(s) | 9.0(13.0) | 97(57.7) | ||
Surgeon performing the operation | 0.003 | 0.953 | ||
Chief physician | 9.0(12.5) | 129(76.8) | ||
Associate chief physician | 9.0(14.0) | 39(23.2) | ||
Open or closed reduction of the fracture | 0.460 | 0.498 | ||
Open reduction and internal fixation | 9.0(12.8) | 164(97.6) | ||
Closed reduction and internal fixation | 21.0(17.3) | 4(2.4) | ||
Postoperative complication(s) | 6.170 | 0.187 | ||
None | 8.0(16.0) | 35(20.8) | ||
Fracture nonunion | 9.0(11.8) | 112(66.7) | ||
Fracture delayed union | 6.0(35.0) | 6(3.6) | ||
Infection | 9.0(14.5) | 9(5.4) | ||
Others | 30.0(42.8) | 6(3.6) | ||
Postsurgical infection(s) | 0.313 | 0.855 | ||
None | 9.0(12.5) | 154(91.7) | ||
Superficial infection | 9.0(18.3) | 8(4.8) | ||
Deep infection | 7.5(18.2) | 6(3.6) | ||
Number of plate holes | 17.119 | <0.001* | ||
< 5 | 25.5(24.5) | 22(13.1) | ||
5–10 | 8.0(8.3) | 69(41.1) | ||
11–15 | 9.0(12.0) | 60(35.7) | ||
> 15 | 6.0(5.5) | 17(10.1) | ||
Number of inserted screws | 6.604 | 0.037* | ||
< 5 | 12.0(25.0) | 40(23.8) | ||
5–10 | 9.0(9.0) | 104(61.9) | ||
10 | 7.0(7.5) | 24(14.3) | ||
Breakage characteristics | ||||
Breakage site within/outside the fracture line | 5.196 | 0.023* | ||
Within | 8.0(10.0) | 132(78.6) | ||
Outside | 11.0(17.3) | 36(21.4) | ||
Screw slack off the hole | 0.068 | 0.794 | ||
None | 9.0(13.0) | 125(74.4) | ||
Yes | 9.0(13.0) | 43(25.6) | ||
Type of broken plate | 17.456 | <0.001* | ||
Plate(s) | 6.5(8.1) | 114(67.9) | ||
Screw(s) | 12.0(19.5) | 54(32.1) | ||
Most possible underlying cause of breakage | 6.384 | 0.172 | ||
Internal fixator improper selection | 10.0(21.8) | 36(21.4) | ||
Premature postoperative training | 10.0(15.0) | 39(23.2) | ||
Too short of a plate utilized | 7.0(8.6) | 34(20.2) | ||
Screw(s) in inappropriate location | 5.0(11.0) | 39(23.2) | ||
Others | 8.0(8.3) | 20(11.9) | ||