Tibial shaft fracture: Incidence, short- and long-term outcomes

The overall purpose of the present PhD thesis was to provide up-to-date information of the epidemiology of tibial shaft fractures and to investigate the development in quality of life, pain and functional outcomes from surgery and onwards, following a tibial shaft fracture treated with intramedullary nailing.

Study I reported an incidence of 16.9/100,000/year from a complete population. Study II reported the long-term patient-reported outcomes and showed that approximately 8 years after the fracture patients reported significantly worse outcome for 4 of the 5 KOOS subscales compared to the reference population. Study III suggested that localized, distal and bilateral hyperalgesia are common within the first 12 months postoperatively. Study IV reported that patients achieved a level of QOL close to an established reference population within the first 12 months postoperatively. However, study IV also showed a significant worse outcome in 3 of the 5 KOOS subscales compared to a reference population at 12-months follow-up. Moreover, this study showed that increasing difference in muscle strength for knee extension between legs was associated with a decreasing QOL.

The results of this thesis suggested that regaining pre injured QOL and muscle strength following a tibial shaft fracture takes considerable time.