Can a combination of different risk factors be correlated with leg fracture healing time?

Leo Massari, Francesco Falez, Vincenzo Lorusso, Giacomo Zanon, Luigi Ciolli, Filippo La Cava, Matteo Cadossi, Eugenio Chiarello, Francesca De Terlizzi, Stefania Setti, Francesco Maria Benazzo

Research output: Contribution to journalArticle

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Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.

Original languageEnglish
Pages (from-to)51-57
Number of pages7
JournalJournal of Orthopaedics and Traumatology
Volume14
Issue number1
DOIs
Publication statusPublished - 2013

Fingerprint

Fracture Healing
Leg
ROC Curve
Weight-Bearing
Osteogenesis
Area Under Curve
Orthopedics
Students
Weights and Measures
Bone and Bones

Keywords

  • Delayed healing
  • Leg fracture
  • Risk factor score

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Can a combination of different risk factors be correlated with leg fracture healing time? / Massari, Leo; Falez, Francesco; Lorusso, Vincenzo; Zanon, Giacomo; Ciolli, Luigi; La Cava, Filippo; Cadossi, Matteo; Chiarello, Eugenio; De Terlizzi, Francesca; Setti, Stefania; Benazzo, Francesco Maria.

In: Journal of Orthopaedics and Traumatology, Vol. 14, No. 1, 2013, p. 51-57.

Research output: Contribution to journalArticle

Massari, L, Falez, F, Lorusso, V, Zanon, G, Ciolli, L, La Cava, F, Cadossi, M, Chiarello, E, De Terlizzi, F, Setti, S & Benazzo, FM 2013, 'Can a combination of different risk factors be correlated with leg fracture healing time?', Journal of Orthopaedics and Traumatology, vol. 14, no. 1, pp. 51-57. https://doi.org/10.1007/s10195-012-0218-7
Massari, Leo ; Falez, Francesco ; Lorusso, Vincenzo ; Zanon, Giacomo ; Ciolli, Luigi ; La Cava, Filippo ; Cadossi, Matteo ; Chiarello, Eugenio ; De Terlizzi, Francesca ; Setti, Stefania ; Benazzo, Francesco Maria. / Can a combination of different risk factors be correlated with leg fracture healing time?. In: Journal of Orthopaedics and Traumatology. 2013 ; Vol. 14, No. 1. pp. 51-57.
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AU - Falez, Francesco

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AU - Ciolli, Luigi

AU - La Cava, Filippo

AU - Cadossi, Matteo

AU - Chiarello, Eugenio

AU - De Terlizzi, Francesca

AU - Setti, Stefania

AU - Benazzo, Francesco Maria

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AB - Background: 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. Methods: 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. Results: 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). Conclusions: 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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