Surgical and conservative treatment of lower limb fractures in patients with chronic spinal cord injury.

Abstract

A 10-year single-center retrospective chart review. To evaluate the differences between conservative and surgical treatment of long bone fractures in individuals with chronic SCI, focusing on wheelchair mobilization, overall hospital days, and complication rates. Spinal cord injury Department, BG Trauma Center Frankfurt am Main, Germany. The study, conducted between 2014 and 2023, compared conservative and surgical treatment for long bone fractures in individuals with chronic SCI using descriptive statistics. Fifty-eight fractures were included (31 surgical, 27 conservative). Baseline characteristics did not differ between groups (p > 0.05). Median time to first wheelchair mobilization was 14 days in both groups (median difference 0 days; 95% CI, -4 to 5; p = 0.38). LOS was comparable (median 45 vs. 46 days; difference -1 day; 95% CI, -7 to 6; p = 0.98). Complications occurred in 1 of 31 surgically treated cases (3.2%) versus 9 of 27 conservatively treated (33.3%), corresponding to a risk difference of -30.1% (95% CI, -48.3 to -11.9; p = 0.002). Non-surgical treatment had a higher complication rate than surgical treatment. Both approaches were equivalent in time to first wheelchair mobilization, and neither showed a significantly shorter hospital stay.