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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)   
  1. *Significant at α = 0.05