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Figure legends
Figure 1. Patient selection flow diagram.
Figure 2. The cumulative incidence of refractures and when refractures occurred postoperatively in
both groups.
19
TABLE 1. Demographic Data and Preoperative Information
Group B (n=79)
Group E (n=64)
p Value
Age, yrs, mean (SD)
9.43 (2.85)
8.78 (3.42)
0.217
Sex, Male/Female, n (%)
60 (75.9)/19 (24.1)
44 (60.8)/19 (30.2)
0.449
Height, cm, mean (SD)
133.38 (18.20)
132.36 (22.95)
0.778
Weight, kg, mean (SD)
31.76 (14.41)
31.43 (13.59)
0.893
BMI percentile (SD)
42.14 (29.03)
47.22 (28.51)
0.325
Injured hand, Right/Left, n (%)
42 (53.2)/37 (46.8)
20 (31.2)/44 (68.8)
0.011*
Sports injury
21 (26.6)
21 (32.8)
0.423
Low energy (falling down)
25 (31.6)
23 (35.9)
High energy (fall from high place/bicycle, etc.)
33 (41.8)
20 (31.2)
2.18 (6.35)
3.31 (8.53)
0.363
Isolated fracture of the radius
9 (11.4)
4 (6.2)
0.297
Isolated fracture of the ulna
5 (6.3)
8 (12.5)
Both bone fractures operated both bones
58 (73.4)
42 (65.6)
Both bone fractures operated isolated radius
5 (6.3)
5 (7.8)
Both bone fractures operated isolated ulna
2 (2.5)
5 (7.8)
22r-D/2.1(green stick)
5 (6.9)
10 (19.6)
22r-D/4.1(complete transverse, simple)
50 (69.4)
27 (52.9)
22r-D/4.2(complete transverse, multi-fragment)
1 (1.4)
1 (2.0)
22r-D/5.1(complete oblique, simple)
16 (22.2)
13 (25.5)
22u-D/1.1(bowing)
2 (2.8)
3 (5.0)
22u-D/2.1(green stick)
11 (15.5)
10 (16.7)
22u-D/4.1(complete transverse, simple)
33 (46.5)
21 (35.0)
22u-D/4.2(complete transverse, multi-fragment)
0 (0.0)
1 (1.7)
22u-D/5.1(complete oblique, simple)
21 (29.6)
18 (30.0)
22u-D/5.2(complete oblique, multi-fragment)
4 (5.6)
6 (10.0)
22u-D/6.1(Monteggia, simple)
0 (0.0)
1 (1.7)
22u-D/6.2(Monteggia, multi-fragment)
2 (2.8)
3 (5.0)
Distal 1/3
14 (19.4)
13 (25.5)
Middle 1/3
36 (50.0)
28 (54.9)
Proximal 1/3
22 (30.6)
10 (19.6)
Injury mechanism, n (%)
Time from injury to surgery, days, mean (SD)
Fracture bone, n (%)
AO classification (R), n (%)
0.102
AO classification (U), n (%)
0.62
Fracture level (R), n (%)
Fracture level (U), n (%)
0.366
Distal 1/3
7 (10.8)
7 (12.7)
0.342
Middle 1/3
40 (61.5)
39 (70.9)
Proximal 1/3
18 (27.7)
9 (16.4)
Compartment syndrome, n (%)
0 (0)
0 (0)
Nerve symptoms, n (%)
5 (6.3)
5 (7.8)
0.753
Preoperative complications
Preoperative radiographic data
Angulation view (R), degrees, mean (SD)
20.82 (14.32)
24.49 (15.38)
0.177
Angulation view (U), degrees, mean (SD)
21.12 (16.29)
23.66 (16.35)
0.397
Displacement (R), n (%)
Minimal displacement or only angulation
11 (15.3)
8 (15.7)
Partial contact
35 (48.6)
33 (64.7)
No contact
26 (36.1)
10 (19.6)
Minimal displacement or only angulation
10 (15.4)
14 (25.5)
Partial contact
31 (47.7)
23 (41.8)
No contact
24 (36.9)
18 (32.7)
0.131
Displacement (U), n (%)
0.423
SD indicates standard deviation; BMI, body mass index; (R), radius; (U), ulna; AP, antero-posterior; ML,
mediolateral.
*p <0.05.
TABLE 2. Surgical Information, Postoperative Management, and Status of Bone Union
Group B
(n=79)
Group E
(n=64)
p Value
56.25 (25.20)
50.80 (36.82)
0.335
Closed reduction
55 (77.5)
45 (90.0)
0.196
Kapandji techniques
8 (11.3)
3 (6.0)
Open reduction
8 (11.3)
2 (4.0)
Closed reduction
53 (81.5)
43 (79.6)
Kapandji techniques
5 (7.7)
5 (9.3)
7 (10.8)
6 (11.1)
Dorsal entry point
35 (48.6)
5 (10.0)
Lateral entry point
37 (51.4)
45 (90.0)
Through olecranon entry point
58 (89.2)
47 (87.0)
Proximal lateral entry point
7 (10.8)
7 (13.0)
Time from operation to splint off, days, mean (SD)
34.07 (12.92)
39.88 (13.08)
0.013*
Time from operation to removal of activity restrictions,
months, mean (SD)
Time from operation to implant removal, days, mean
(SD)
Anesthesia for implant removal
3.83 (1.85)
3.05 (0.71)
0.014*
187.90 (107.91)
41.39 (24.26)
<0.001*
No or local anesthesia
17 (21.5)
52 (82.5)
General or regional anesthesia,
62 (78.5)
11 (17.5)
<0.001*
mRUST score at 3 months (R), median [range]
15.00 [8.00, 16.00]
15.00 [8.00, 16.00]
0.444
mRUST score at 3 months (U), median [range]
14.00 [6.00, 16.00]
14.00 [8.00, 16.00]
0.83
mRUST score at 6 months (R), median [range]
16.00 [11.00, 16.00]
16.00 [12.00, 16.00]
0.402
mRUST score at 6 months (U), median [range]
16.00 [12.00, 16.00]
16.00 [12.00, 16.00]
0.768
Surgical information
Operative time, min, mean (SD)
Reduction(R), n (%)
Reduction(U), n (%)
Open reduction
Insertion position of K-wire (R), n (%)
0.943
<0.001*
Insertion position of K-wire (U), n (%)
0.78
Postoperative management including implant removal
Status of bone union
SD indicates standard deviation; K-wire, Kirshner wire; mRUST, modified radiographic union scale in tibial
fractures; (R), radius; (U), ulna.
*p <0.05.
Table.3 Postoperative Complications
Group B
Group E
(n=79)
(n=64)
p.value
Refracture, n (%)
6 (7.9)
21(32.8)
Infection, n (%)
3 (3.8)
7(10.9)
0.112
Nerve injury, n (%)
1 (1.2)
0 (0.0)
Tendon rupture, n (%)
Irritation pain, n (%)
Nonunion
Penetration of implant through skin（％）
*p <.05
12 (15.2)
４（5.1）
1 (1.6)
<0.001*
0.006*
Table.4 Comparison of mRUST score between patients with and without refracture
Refracture cases
No refracture cases
p.value
mRUST score at 3month (R), median (range)
15.00 [8.00, 16.00]
15.00[8.00, 16.00]
0.96
mRUST score at 3month (U), median (range)
14.00 [9.00, 16.00]
14.00 [6.00, 16.00]
0.644
mRUST score at 6month (R), median (range)
16.00 [13.00, 16.00]
16.00 [12.00, 16.00]
0.93
mRUST score at 6month (U), median (range)
15.00 [12.00, 16.00]
16.00 [11.00, 16.00]
0.139
Abbreviations: mRUST, modified radiographic union scale in tibial fractures;
(R), Radius; (U), Ulna; *p <.05
...
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