Outcome validation of the AO/OTA fracture classification system.
OBJECTIVE
To determine whether a greater severity of injury as documented by the AO/OTA code would correlate with poor scores of impairment, functional performance, and self-reported health status.


METHODS
Prospective, functional outcome.


METHODS
Three Level One Trauma Centers.


METHODS
Two hundred patients with unilateral and isolated lower extremity fractures.


METHODS
Six- and twelve-month SIP, AMA impairment, and functional performance measures of self-selected walking speed, stair climbing, heel raises, rising from a chair, balance work.


RESULTS
At six months post injury, overall impairment was significantly (p < 0.05) higher for patients with Type C versus Type B fractures. A significant difference was found among the A, B, C types and the ROM impairment rating at six months (p = 0.004). Using the Scheffe method, the significant difference was determined to be between the B- and C-type fractures. Overall functional performance scores at six months were shown to have significant (p = 0.01) variation using an ANOVA with the significant variation being between the B and C type. At twelve months, the overall functional performance was significant (p = 0.05).


CONCLUSIONS
Patients with C-type fractures had significantly worse functional performance and impairment compared with patients with B-type fractures but were not significantly different from patients with A-type fractures. AO/OTA code may not be a good predictor of six- and twelve-month functional performance and impairment for patients with isolated unilateral lower extremity fractures.
Swiontkowski
M F
MF
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis 55455, USA.
Agel
J
J
McAndrew
M P
MP
Burgess
A R
AR
MacKenzie
E J
EJ
D000704:Analysis of Variance; D005260:Female; D050723:Fractures, Bone / Q000145:classification* / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D007869:Leg Injuries / Q000145:classification*; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D012955:Societies, Medical