Decreased muscle strength is associated with impaired long-term functional outcome after intramedullary nailing of femoral shaft XXXX .

@entity1 @entity571 @entity174 @entity158 @entity717
PURPOSE: To examine the long-term outcome after intramedullary nailing of femoral diaphysial fractures measured as disease-specific @entity1 reported function, walking ability, muscle strength, @entity158 and quality of life (QOL). METHODS: Cross-sectional study. Retrospective review and follow-up with clinical examination of 48 @entity1 treated with intramedullary nailing after femoral shaft @entity174 between 2007 and 2010. The @entity1 underwent a clinical examination and assessment of walking ability, maximal muscle strength during knee flexion and extension and hip abduction. @entity717 and @entity571 Outcome Score (HOOS) and questionnaire evaluating QOL (Eq5D-5L) were completed by @entity1 . RESULTS: Fourty-eight @entity1 agreed to participate. Mean time for follow-up was 4.7  years. The mean HOOS scores were 84.9 ( @entity158 ), 86.6 (ADL), 85.0 (Symptoms), 72.6 (QOL), and 69.1 (Sport). The mean muscle strength of knee flexion with the injured leg (226.0  N) was significantly lower then knee flexion with the non-injured leg (259.5  N, P  <  0.0001). Likewise for knee extension (335.2 vs 406.4  N, P  <  0.001) and hip abduction (129.2 vs 156.0  N, P  <  0.001). Significant association between HOOS and an increase in the difference in muscle strength were observed as well as between worse HOOS outcome and increasing body mass index. CONCLUSION: This study showed that decreased muscle strength for knee flexion, knee extension and hip abduction was associated with worse long-term functional outcome measured with a disease-specific questionnaire (HOOS) after intramedullary nailing of femoral shaft @entity174 .
