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    Incidence, Costs and Predictors of Non-Union, Delayed Union and Mal-Union Following Long Bone Fracture

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    Author
    Ekegren, CL; Edwards, ER; de Steiger, R; Gabbe, BJ
    Date
    2018-12-01
    Source Title
    International Journal of Environmental Research and Public Health
    Publisher
    MDPI
    University of Melbourne Author/s
    de Steiger, Richard
    Affiliation
    Surgery (RMH)
    Metadata
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    Document Type
    Journal Article
    Citations
    Ekegren, C. L., Edwards, E. R., de Steiger, R. & Gabbe, B. J. (2018). Incidence, Costs and Predictors of Non-Union, Delayed Union and Mal-Union Following Long Bone Fracture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 15 (12), https://doi.org/10.3390/ijerph15122845.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253378
    DOI
    10.3390/ijerph15122845
    Abstract
    Fracture healing complications are common and result in significant healthcare burden. The aim of this study was to determine the rate, costs and predictors of two-year readmission for surgical management of healing complications (delayed, mal, non-union) following fracture of the humerus, tibia or femur. Humeral, tibial and femoral (excluding proximal) fractures registered by the Victorian Orthopaedic Trauma Outcomes Registry over five years (n = 3962) were linked with population-level hospital admissions data to identify two-year readmissions for delayed, mal or non-union. Study outcomes included hospital length-of-stay (LOS) and inpatient costs. Multivariable logistic regression was used to determine demographic and injury-related factors associated with admission for fracture healing complications. Of the 3886 patients linked, 8.1% were readmitted for healing complications within two years post-fracture, with non-union the most common complication and higher rates for femoral and tibial shaft fractures. Admissions for fracture healing complications incurred total costs of $4.9 million AUD, with a median LOS of two days. After adjusting for confounders, patients had higher odds of developing complications if they were older, receiving compensation or had tibial or femoral shaft fractures. Patients who are older, with tibial and femoral shaft fractures should be targeted for future research aimed at preventing complications.

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