Introduction
Methods
Patients
Design
Fracture classification
Measures
Statistical analyses
Results
Total
n = 543 (100) | |
---|---|
Age (years, n = 543) | 57.0 ± 16.6 (59, 18-97) |
Sex (n = 543) | |
Male | 150 (27.6) |
Female | 393 (72.4) |
Marital status (n = 517) | |
Partner | 388 (75.0) |
No partner | 129 (25.0) |
Educational level (n = 471) | |
Low: high school or less | 228 (48.4) |
High: additional education after high school | 243 (51.6) |
Employment (n = 531) | |
Employed | 252 (47.5) |
Unemployed | 279 (52.5) |
Smoking (n = 525) | |
Yes | 83 (15.8) |
No | 442 (84.2) |
Chronic comorbidities (n = 524) | |
Yes | 183 (34.9) |
No | 341 (65.1) |
Type of injury (n = 533) | |
Traffic | 62 (11.6) |
Work place | 38 (7.1) |
Home environment | 142 (26.6) |
Sports | 96 (18.0) |
Other | 195 (36.6) |
Type of fracture (n = 543) | |
Distal radius fracture | 297 (54.7) |
Ankle fracture | 246 (45.3) |
AO classification (n = 543) | |
23/44A | 198 (36.5) |
23/44A1 | 76 (14.0) |
23/44A2 | 64 (11.8) |
23/44A3 | 58 (10.7) |
23/44B | 164 (30.2) |
23/44B1 | 98 (18.0) |
23/44B2 | 30 (5.5) |
23/44B3 | 36 (6.6) |
23/44C | 169 (31.1) |
23/44C1 | 47 (8.7) |
23/44C2 | 54 (9.9) |
23/44C3 | 68 (12.5) |
Isolated medial malleolus fractureb
| 12 (2.2) |
Type of treatment (n = 543) | |
Operative | 159 (29.3) |
Non-operative | 384 (70.7) |
QOLc
| |
Overall QOL and general health (n = 458) | 8.3 ± 1.3 |
Physical health (n = 456) | 16.8 ± 2.5 |
Psychological health (n = 457) | 15.8 ± 2.2 |
Social relationships (n = 460) | 16.0 ± 2.7 |
Environment (n = 456) | 16.8 ± 2.3 |
Trajectories of QOL
Dependent variable | Analyzed as continuous or ordinal variable | Nr of classes |
R
2
| Wald(0)a
p value | Wald(=)a
p value |
---|---|---|---|---|---|
Overall QOL and general health | Ordinal (4 categories) | 3 | .72 |
<0.001
| 0.87 |
Physical health | Continuous | 4 | .75 |
<0.001
|
<0.001
|
Psychological health | Continuous | 5 | .78 |
<0.001
|
0.009
|
Social relationships | Ordinal (7 categories) | 3 | .72 |
0.023
|
0.01
|
Environment | Continuous | 4 | .79 |
<0.001
|
0.004
|
No of classes | Overall QOL and general health (ordinal: 4 categories) | Physical health | Psychological health | Social relationships (ordinal: 7 categories) | Environment |
---|---|---|---|---|---|
1 | 3859,573 | 6751,418 | 6353,137 | 5415,529 | 6425,771 |
2 | 3468,745 | 6147,457 | 5837,232 | 5035,959 | 5837,804 |
3 |
3412,713
| 5982,306 | 5696,122 |
4933,103
| 5628,515 |
4 | 3414,700 |
5946,118
| 5672,432 | 4955,431 |
5530,121
|
5 | 3440,841 | 5957,006 |
5665,538
| 4988,167 | 5531,857 |
6 | 3473,686 | 5967,387 | 5672,167 | 5021,783 | 5535,287 |
7 | 3513,532 | 5983,384 | 5689,382 | 5064,903 | 5553,142 |
8 | 3544,726 | 5994,313 | 5708,427 | 5117,752 | 5569,405 |
Characteristics | Overall QOL and general health (ordinal) | Physical health | |||||||
---|---|---|---|---|---|---|---|---|---|
Class 1 Poor (N = 158; 29.4%) | Class 2 Moderate (N = 179; 33.3%) | Class 3 Good (N = 200; 37.2%) |
p value corrected | Class 1 Poor (N = 106; 20.1%) | Class 2 Moderate (N = 155; 29.4%) | Class 3 Good (N = 181; 34.3%) | Class 4 Excellent (N = 86; 16.3%) |
p value corrected | |
Sociodemographic characteristics | |||||||||
Age | 60.8 ± 15.1 | 57.4 ± 16.6 | 53.4 ± 17.2 |
<0.001
| 59.6 ± 16.0 | 60.4 ± 15.9 | 53.8 ± 16.7 | 52.4 ± 16.7 |
<0.001
|
Sex | |||||||||
Male | 37 (23.4) | 45 (25.1) | 66 (33.0) | 0.098 | 26 (24.5) | 29 (18.7) | 62 (34.3) | 31 (36.0) |
0.013
|
Female | 121 (76.6) | 134 (74.9) | 134 (67.0) | 80 (75.5) | 126 (81.3) | 119 (65.7) | 55 (64.0) | ||
Partner | |||||||||
Yes | 95 (66.0) | 133 (77.3) | 157 (80.1) |
0.014
| 66 (67.3) | 101 (68.7) | 147 (83.1) | 68 (81.0) |
0.015
|
No | 49 (34.0) | 39 (22.7) | 39 (19.9) | 32 (32.7) | 46 (31.3) | 30 (16.9) | 16 (19.0) | ||
Educational level | |||||||||
Low education | 76 (60.8) | 80 (51.6) | 70 (37.4) |
<0.001
| 55 (65.5) | 76 (57.6) | 63 (38.2) | 27 (33.3) |
<0.001
|
High education | 49 (39.2) | 75 (48.4) | 117 (62.6) | 26 (34.5) | 56 (42.4) | 102 (61.8) | 54 (66.7) | ||
Employment | |||||||||
Yes | 55 (36.4) | 87 (49.2) | 108 (54.5) |
<0.001
| 29 (28.4) | 67 (44.1) | 104 (57.8) | 49 (58.3) |
<0.001
|
No | 96 (63.6) | 90 (50.8) | 90 (45.5) | 73 (71.6) | 85 (55.9) | 76 (42.2) | 35 (41.7) | ||
Clinical characteristics | |||||||||
Smoking | |||||||||
Yes | 32 (21.2) | 32 (18.5) | 18 (9.2) |
0.01
| 20 (19.8) | 24 (16.1) | 30 (16.8) | 8 (9.6) | 0.43 |
No | 119 (78.8) | 141 (81.5) | 178 (90.8) | 81 (80.2) | 125 (83.9) | 149 (83.2) | 75 (90.4) | ||
Chronic comorbidities | |||||||||
Yes | 94 (62.7) | 55 (31.6) | 33 (16.9) |
<0.001
| 65 (65.0) | 54 (36.2) | 47 (26.3) | 12 (14.5) |
<0.001
|
No | 56 (37.3) | 119 (68.4) | 162 (83.1) | 35 (35.0) | 95 (63.8) | 132 (73.7) | 71 (85.5) | ||
Diagnosis | |||||||||
Distal radius fracture | 92 (58.2) | 98 (54.7) | 104 (52.0) | 0.27 | 54 (50.9) | 92 (59.4) | 96 (53.0) | 45 (52.3) | 0.35 |
Ankle fracture | 66 (41.8) | 81 (45.3) | 96 (48.0) | 52 (49.1) | 63 (40.6) | 85 (47.0) | 41 (47.7) | ||
AO classification | |||||||||
Group A | 62 (40.0) | 65 (37.1) | 68 (34.9) | 0.64 | 37 (35.9) | 62 (40.5) | 64 (36.0) | 28 (34.1) | 0.99 |
Group B | 46 (29.7) | 52 (29.7) | 64 (32.8) | 34 (33.0) | 43 (28.1) | 56 (31.5) | 28 (34.1) | ||
Group C | 47 (30.3) | 58 (33.1) | 63 (32.3) | 32 (31.1) | 48 (31.4) | 58 (32.6) | 26 (31.7) | ||
Type of treatment | |||||||||
Non-operative | 116 (73.4) | 122 (68.2) | 140 (70.0) | 0.54 | 74 (69.8) | 111 (71.6) | 117 (64.6) | 67 (77.9) | 0.21 |
Operative | 42 (26.6) | 57 (31.8) | 60 (30.0) | 32 (30.2) | 44 (28.4) | 64 (35.4) | 19 (22.1) | ||
Psychological characteristics | |||||||||
Trait anxiety | 19.2 ± 5.8 | 16.3 ± 4.4 | 13.4 ± 3.2 |
<0.001
| 19.7 ± 5.8 | 17.3 ± 5.0 | 14.3 ± 3.7 | 12.9 ± 2.8 |
<0.001
|
Neuroticism | 30.9 ± 7.1 | 27.5 ± 6.7 | 23.0 ± 6.4 |
<0.001
| 31.0 ± 7.0 | 29.3 ± 7.2 | 25.0 ± 6.25 | 20.8 ± 5.5 |
<0.001
|
Extraversion | 39.0 ± 6.6 | 41.7 ± 6.1 | 44.3 ± 6.2 |
<0.001
| 39.8 ± 6.8 | 40.3 ± 6.4 | 42.5 ± 6.4 | 46.2 ± 5.1 |
<0.001
|
Pain catastrophizing | 2.5 ± 0.9 | 2.1 ± 0.7 | 1.8 ± 0.6 |
<0.001
| 2.8 ± .9 | 2.1 ± .7 | 1.9 ± .6 | 1.7 ± .6 |
<0.001
|
Pain coping | 3.5 ± 0.9 | 3.6 ± 0.9 | 3.6 ± 1.0 | 0.42 | 3.5 ± .9 | 3.6 ± .9 | 3.6 ± .9 | 3.4 ± 1.0 | 0.49 |
Internal locus of pain control | 3.6 ± 1.0 | 3.8 ± 0.8 | 4.0 ± 0.9 |
<0.001
| 3.4 ± 1.0 | 3.9 ± .8 | 4.0 ± .9 | 4.0 ± 1.0 |
<0.001
|
External locus of pain control | 3.0 ± 1.0 | 2.8 ± 0.9 | 2.6 ± 0.9 |
<0.001
| 3.0 ± .9 | 3.0 ± 1.0 | 2.7 ± .9 | 2.5 ± .9 |
<0.001
|
Characteristics | Psychological health | |||||
---|---|---|---|---|---|---|
Class 1 Poor (N = 69; 13.0%) | Class 2 Moderate (N = 78; 14.7%) | Class 3 Adequate (N = 248; 46.7%) | Class 4 Good (N = 94; 17.7%) | Class 5 Excellent (N = 42; 7.9%) |
p value corrected | |
Sociodemographic characteristics | ||||||
Age | 57.4 ± 16.4 | 62.0 ± 16.5 | 55.2 ± 16.7 | 56.0 ± 15.7 | 57.3 ± 18.3 |
0.039
|
Sex | ||||||
Male | 13 (18.8) | 13 (16.7) | 73 (29.4) | 33 (35.1) | 15 (35.7) |
0.029
|
Female | 56 (81.2) | 65 (83.3) | 175 (70.6) | 61 (64.9) | 27 (64.3) | |
Partner | ||||||
Yes | 40 (63.5) | 50 (68.5) | 178 (74.5) | 81 (87.1) | 34 (82.9) |
0.012
|
No | 23 (36.5) | 23 (31.5) | 61 (25.5) | 12 (12.9) | 7 (17.1) | |
Educational level | ||||||
Low education | 36 (66.7) | 36 (57.1) | 92 (42.2) | 41 (45.1) | 17 (45.9) |
0.006
|
High education | 18 (33.3) | 27 (42.9) | 126 (57.8) | 50 (54.9) | 20 (54.1) | |
Employment | ||||||
Yes | 27 (40.3) | 26 (33.3) | 129 (53.1) | 45 (48.4) | 22 (53.7) |
0.029
|
No | 40 (59.7) | 52 (66.7) | 114 (46.9) | 48 (51.6) | 19 (46.3) | |
Clinical characteristics | ||||||
Smoking | ||||||
Yes | 13 (19.7) | 16 (21.1) | 36 (14.8) | 13 (14.0) | 4 (10.5) | 0.32 |
No | 53 (80.3) | 60 (78.9) | 207 (85.2) | 80 (86.0) | 34 (89.5) | |
Chronic comorbidities | ||||||
Yes | 35 (53.8) | 32 (41.6) | 86 (35.7) | 22 (23.4) | 6 (15.8) |
<0.001
|
No | 30 (46.2) | 45 (58.4) | 155 (64.3) | 72 (76.6) | 32 (84.2) | |
Diagnosis | ||||||
Distal radius fracture | 47 (68.1) | 47 (60.3) | 124 (50.0) | 49 (52.1) | 23 (54.8) | 0.21 |
Ankle fracture | 22 (31.9) | 31 (39.7) | 124 (50.0) | 45 (47.9) | 19 (45.2) | |
AO classification | ||||||
Group A | 27 (39.1) | 40 (51.9) | 85 (35.0) | 30 (34.1) | 11 (26.2) | 0.15 |
Group B | 23 (33.3) | 17 (22.1) | 80 (32.9) | 26 (29.5) | 16 (38.1) | |
Group C | 19 (27.5) | 20 (26.0) | 78 (32.1) | 32 (36.4) | 15 (35.7) | |
Type of treatment | ||||||
Non-operative | 52 (75.4) | 56 (71.8) | 169 (68.1) | 66 (70.2) | 30 (71.4) | 0.56 |
Operative | 17 (24.6) | 22 (28.2) | 79 (31.9) | 28 (29.8) | 12 (28.6) | |
Psychological characteristics | ||||||
Trait anxiety | 22 ± 6.1 | 20.0 ± 4.1 | 15.1 ± 3.7 | 13.1 ± 2.9 | 11.9 ± 2.2 |
<0.001
|
Neuroticism | 34.4 ± 7.2 | 31.3 ± 5.4 | 26.3 ± 6.3 | 22.5 ± 5.1 | 19.0 ± 6.1 |
<0.001
|
Extraversion | 37.0 ± 6.3 | 38.8 ± 6.5 | 42.1 ± 6.2 | 44.8 ± 4.9 | 47.4 ± 5.5 |
<0.001
|
Pain catastrophizing | 2.6 ± .9 | 2.3 ± .7 | 2.1 ± .7 | 1.8 ± .7 | 1.5 ± .5 |
<0.001
|
Pain coping | 3.6 ± .8 | 3.4 ± .9 | 3.6 ± 1.0 | 3.6 ± .9 | 3.8 ± 1.1 | 0.44 |
Internal pain locus of control | 3.5 ± .9 | 3.6 ± .8 | 3.9 ± .9 | 4.0 ± .9 | 4.1 ± 1.1 |
<0.001
|
External pain locus of control | 3.0 ± 1.0 | 2.8 ± .8 | 2.8 ± 1.0 | 2.7 ± .9 | 2.7 ± .9 | 0.47 |
Characteristics | Social relationships (ordinal) | Environment | |||||||
---|---|---|---|---|---|---|---|---|---|
Class 1 Poor (N = 143; 26.8%) | Class 2 Moderate (N = 208; 39.0%) | Class 3 Good (N = 183; 34.3%) |
p value corrected | Class 1 Poor (N = 90; 16.9) | Class 2 Moderate (N = 197; 37.1%) | Class 3 Good (N = 171; 32.3%) | Class 4 Excellent (N = 73; 13.7) |
p value corrected | |
Sociodemographic characteristics | |||||||||
Age | 60.0 ± 15.8 | 57.3 ± 16.7 | 54.3 ± 16.8 | 0.065 | 61.8 ± 14.6 | 55.6 ± 17.2 | 54.6 ± 16.8 | 58.1 ± 15.6 |
0.005
|
Sex | |||||||||
Male | 39 (27.3) | 65 (31.3) | 45 (24.6) | 0.33 | 22 (24.4) | 59 (29.9) | 47 (27.5) | 21 (28.8) | 0.87 |
Female | 104 (72.7) | 143 (68.8) | 138 (75.4) | 68 (75.6) | 138 (70.1) | 124 (72.5) | 52 (71.2) | ||
Partner | |||||||||
Yes | 86 (64.2) | 155 (78.3) | 145 (81.5) |
0.004
| 49 (59.8) | 139 (73.9) | 134 (80.2) | 62 (87.3) |
<0.001
|
No | 48 (35.8) | 43 (21.7) | 33 (18.5) | 33 (40.2) | 49 (26.1) | 33 (19.8) | 9 (12.7) | ||
Educational level | |||||||||
Low education | 64 (57.7) | 86 (47.3) | 72 (41.9) | 0.064 | 51 (75.0) | 94 (55.3) | 49 (31.4) | 28 (40.6) |
<0.001
|
High education | 47 (42.3) | 96 (52.7) | 100 (58.1) | 17 (25.0) | 76 (44.7) | 107 (68.6) | 41 (59.4) | ||
Employment | |||||||||
Yes | 53 (38.4) | 98 (48.0) | 100 (55.2) |
0.04
| 25 (29.1) | 95 (49.2) | 101 (59.4) | 28 (39.4) |
<0.001
|
No | 85 (61.6) | 106 (52.0) | 81 (44.8) | 61 (70.9) | 98 (50.8) | 69 (40.6) | 43 (60.6) | ||
Clinical characteristics | |||||||||
Smoking | |||||||||
Yes | 29 (21.2) | 33 (16.6) | 21 (11.6) |
.048
| 22 (26.2) | 29 (15.2) | 23 (13.8) | 8 (11.1) |
0.015
|
No | 108 (78.8) | 166 (83.4) | 160 (88.4) | 62 (73.8) | 162 (84.8) | 144 (86.2) | 64 (88.9) | ||
Chronic comorbidities | |||||||||
Yes | 59 (44.0) | 77 (38.3) | 44 (24.3) |
0.001
| 49 (59.8) | 67 (35.1) | 48 (28.6) | 15 (20.8) |
<0.001
|
No | 75 (56.0) | 124 (61.7) | 137 (75.7) | 33 (40.2) | 124 (64.9) | 120 (71.4) | 57 (79.2) | ||
Diagnosis | |||||||||
Distal radius fracture | 81 (56.6) | 116 (55.8) | 95 (51.9) | 0.7 | 59 (65.6) | 100 (50.8) | 85 (49.7) | 46 (63.0) | 0.055 |
Ankle fracture | 62 (43.4) | 92 (44.2) | 88 (48.1) | 31 (34.4) | 97 (49.2) | 86 (50.3) | 27 (37.0) | ||
AO classification | |||||||||
Group A | 61 (43.3) | 71 (34.8) | 61 (34.5) | 0.27 | 39 (43.3) | 68 (35.6) | 62 (37.1) | 24 (33.8) | 0.68 |
Group B | 40 (28.4) | 63 (30.9) | 60 (33.9) | 26 (28.9) | 57 (29.8) | 56 (33.5) | 23 (32.4) | ||
Group C | 40 (28.4) | 70 (34.3) | 56 (31.6) | 25 (27.8) | 66 (34.6) | 49 (29.3) | 24 (33.8) | ||
Type of treatment | |||||||||
Non-operative | 107 (74.8) | 142 (68.3) | 126 (68.9) | 0.32 | 68 (75.6) | 132 (67.0) | 117 (68.4) | 55 (75.3) | 0.27 |
Operative | 36 (25.2) | 66 (31.7) | 57 (31.1) | 22 (24.4) | 65 (33.0) | 54 (31.6) | 18 (24.7) | ||
Psychological characteristics | |||||||||
Trait anxiety | 19.1 ± 5.7 | 15.7 ± 4.5 | 13.9 ± 3.7 |
<0.001
| 20.6 ± 5.3 | 16.6 ± 5.2 | 14.3 ± 3.6 | 13.3 ± 3.1 |
<0.001
|
Neuroticism | 30.7 ± 7.3 | 26.8 ± 6.4 | 23.5 ± 7.1 |
<0.001
| 32.2 ± 6.5 | 28.1 ± 6.9 | 24.2 ± 6.8 | 22.7 ± 6.6 |
<0.001
|
Extraversion | 38.7 ± 6.4 | 41.0 ± 6.0 | 45.4 ± 5.9 |
<0.001
| 39.0 ± 6.7 | 40.6 ± 6.0 | 48.8 ± 6.1 | 44.4 ± 7.3 |
<0.001
|
Pain catastrophizing | 2.3 ± 0.8 | 2.2 ± 0.7 | 1.9 ± 0.8 |
<0.001
| 2.6 ± 0.8 | 2.2 ± 0.7 | 2.0 ± 0.7 | 1.7 ± 0.6 |
<0.001
|
Pain coping | 3.5 ± 0.9 | 3.6 ± 0.9 | 3.6 ± 1.0 | 0.46 | 3.6 ± 1.0 | 3.5 ± 0.8 | 3.7 ± 1.0 | 3.6 ± 1.1 | 0.42 |
Internal pain locus of control | 3.6 ± 0.9 | 3.9 ± 0.9 | 3.9 ± 0.9 |
0.008
| 3.5 ± 0.8 | 3.8 ± 0.9 | 4.0 ± 0.9 | 4.0 ± 1.0 |
<0.001
|
External pain locus of control | 2.8 ± 1.1 | 2.8 ± 0.9 | 2.7 ± 0.9 | 0.46 | 3.3 ± 1.0 | 2.8 ± 0.9 | 2.6 ± 0.9 | 2.5 ± 1.0 |
<0.001
|