Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study

Massari,; aEmail Author, L.; Benazzo,; bEmail Author, F.; Falez,; cEmail Author, F.; Cadossi,; dEmail Author, R.; Perugia,; eEmail Author, D.; Pietrogrande,; fEmail Author, L.; Aloj,; gEmail Author, D. C.; Capone,; hEmail Author, A.; D'Arienzo,; iEmail Author, M.; Cadossi,; jEmail Author, M.; Lorusso,; aEmail Author, V.; Caruso,; aEmail Author, G.; Ghiara,; bEmail Author, M.; Ciolli,; cEmail Author, L.; Cava, La; cEmail Author, F.; Guidi,; eEmail Author, M.; Castoldi,; gEmail Author, F.; Marongiu,; hEmail Author, G.; Gattuta, La; iEmail Author, A.; Dell'Omo, Dario; kEmail Author, D.; Scaglione, Michelangelo; kEmail Author, M.; Giannini,; jEmail Author, S.; Fortina,; lEmail Author, M.; Riva,; lEmail Author, A.; Palma, De; mEmail Author, P. L.; Gigante,; mEmail Author, A. P.; Moretti,; nEmail Author, B.; Solarino,; nEmail Author, G.; Lijoi,; oEmail Author, F.; Giordano, G. o.

doi:10.1155/2018/1809091

Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time. Methods: The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. Results: 319 fractures (88%) healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r = 0.63 (p < 0.0001). Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. Conclusions: This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings.