Patient-oriented functional outcome after unilateral lower extremity fracture

Ellen J. MacKenzie, Andrew R. Burgess, Mark P. McAndrew, Marc F. Swiontkowski, Brad M. Cushing, Barbara J. Delateur, Gregory J. Jurkovich, John A. Morris

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75 Scopus citations

Abstract

To determine patient-perceived functional outcome after lower extremity fracture (LEF), a prospective, follow-up study of patients managed at three level I trauma centers was conducted. Patients with unilateral LEF involving the acetabulum and distally were eligible for the study. A total of 444 patients were enrolled. Of these, 363 (82%) were interviewed at 6 months postdischarge. Study patients were predominantly young (mean age 34 years), white (72%) men (71%) who had been working preinjury (78%). Their injuries resulted primarily from motor vehicle crashes (73%); 30% had more than one fracture to the same extremity. Functional status was measured using the Sickness Impact Profile (SIP), a well-validated, general health status instrument. Mean 6-month SIP scores were significantly worse (higher) than those based on preinjury activities (9.8 vs. 2.5) (p < 0.01). Overall disability levels were moderate compared with other health conditions. Analysis of the 12 subscores comprising the SIP indicated particularly high scores in ambulation (16.2 postdischarge vs. 1.1 preinjury), sleep/rest (13.1 vs. 5.1), household management (14.5 vs. 2.6), recreation (17.6 vs. 4.2), emotional well-being (9.9 vs. 2.1), and most significantly work (33.2 vs. 8.8). Of those working preinjury, only 49% had returned by 6 months. SIP scores were highest for persons with three or more fractures to the same extremity and for fracture patterns typical of high-energy forces.

Original languageEnglish (US)
Pages (from-to)393-401
Number of pages9
JournalJournal of orthopaedic trauma
Volume7
Issue number5
DOIs
StatePublished - Oct 1993

Keywords

  • Disability
  • Health status
  • Lower extremity fracture
  • Outcome
  • Sickness Impact Profile

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