Strategies in Trauma and Limb Reconstruction

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VOLUME 16 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Patient-reported Outcome and Quality of Life after Treatment with External Fixation: A Questionnaire-based Survey

Shuhei Ugaji, Hidenori Matsubara, Satoshi Kato, Yasuhisa Yoshida, Tomo Hamada

Keywords : External fixators, Pain, Patient satisfaction, Surveys and questionnaires, Taylor Spatial Frame, Walking

Citation Information :

DOI: 10.5005/jp-journals-10080-1519

License: CC BY-NC-SA 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Background: This survey aims to assess the satisfaction of patients who have had treatment using external fixation (EF). Materials and methods: An original questionnaire and a Short Form 36 (SF-36) were distributed to 121 patients who underwent treatment using EF for deformity correction and lengthening between 2006 and 2016. A multivariate analysis was performed on the factors associated with satisfaction. Results: Sixty patients returned a response. The average satisfaction score was 83.6 points. In the 5-point satisfaction survey, 43 of 60 patients (71.7%) responded “very satisfied” or “satisfied” and 27 patients (45.0%) responded “yes” to the question as to whether they would request EF treatment again if presenting with the original preoperative condition. In addition, the subjectively expressed tolerance for having an external fixator device on the limb was 92.1 days on average. A correlation was established with the ISOLS score. Conclusion: The top three factors that determined subjective inconvenience with EF are pain, walking, and heaviness. Although EF treatment was stressful, the satisfaction scores were high. Furthermore, the satisfaction with EF treatment was improved by (1) pain control, (2) shortening the EF period, and (3) psychological support.


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  1. Tsuchiya H, Tomita K, Minematsu K, et al. Limb salvage using distraction osteogenesis. A classification of the technique. J Bone Joint Surg Br 1997;79(4):403–411. DOI: 10.1302/0301-620x.79b3.7198.
  2. Matsubara H, Tsuchiya H. Treatment of bone tumor using external fixation. J Orthop Sci 2019;24(1):1–8. DOI: 10.1016/j.jos.2018.06.022.
  3. Watanabe K, Tsuchiya H, Sakurakichi K, et al. Treatment of lower limb deformities and limb-length discrepancies with the external fixator in Ollier's disease. J Orthop Sci 2007;12(5):471–475. DOI: 10.1007/s00776-007-1163-9.
  4. Kirane YM, Fragomen AT, Rozbruch SR. Precision of the PRECICE® internal bone lengthening nail. Clin Orthop Relat Res 2014;472(12):3869–3878. DOI: 10.1007/s11999-014-3575-0.
  5. Zhang YT, Jin D, Niu J, et al. A meta-analysis of external fixation and flexible intramedullary nails for femoral fractures in children. Acta Orthop Belg 2016;82(4):673–680. DOI: 10.1097/bpb.0000000000000336.
  6. Schnidel F, Vogt B, Wacker S, et al. Walking ability of children with a hexapod external ring fixator (TSF®) and foot plate mounting at the lower leg. Gatit Posture 2012;36(3):500–505. DOI: 10.1016/j.gaitpost.2012.05.006.
  7. Harris IA, Dao AT, Young JM, et al. Predictors of patient and surgeon satisfaction after orthopaedic trauma. Injury 2009;40(4):377–384. DOI: 10.1016/j.injury.2008.08.039.
  8. Kato S, Murakami H, Demura S, et al. Patient-reported outcome and quality of life after total en bloc spondylectomy for a primary spinal tumor. Bone Joint J 2014;96-B(12):1693–1698. DOI: 10.1302/0301-620X.96B12.33832.
  9. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30(6):473–483. DOI: 10.1097/00005650-199401000-00004.
  10. Fukuhara S, Bito S, Green J, et al. Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 1998;51(11):1037–1044. DOI: 10.1016/s0895-4356(98)00095-x.
  11. Tetsworth K, Paley D, Sen C, et al. Bone transport versus acute shortening for the management of infected tibial non-unions with bone defects. Injury 2017;48(10):2276–2284. DOI: 10.1016/j.injury.2017.07.018.
  12. Capanna R, Morris HG, Campanacci D, et al. Modular uncemented prosthetic reconstruction after resection of tumor of the distal femur. J Bone Joint Surg Br 1994;76(2):178–186. DOI: 10.1302/0301-620X.76B2.8113272
  13. Erfelder E, Faul F, Bauchner A. G power: a general power analysis program. Behav Res Methods Insrtum Comput 1996;28(1):1–11. DOI: 10.3758/bf03193146.
  14. Napora JK, Weinberg DS, Eagle BA, et al. Hexapod stacked transport for tibial infected nonunions with bone loss: long-term functional outcomes. J Orthop Trauma 2018;32(1):12–18. DOI: 10.1097/BOT.0000000000001005.
  15. Meleppuram JJ, Ibrahim S. Experience in fixation of infected non-union tibia by Ilizarov technique – a retrospective study of 42 cases. Rev Bras Orthop 2016;52(6):670–675. DOI: 10.1016/j.rboe.2016.11.008.
  16. Montpetit K, Hamdy RC, Dahan ON, et al. Measurement of health-related quality of life in children undergoing external fixator treatment for lower limb deformity. J Pediatr Orthop 2009;8:920–926. DOI: 10.1097/BPO.0b013e3181c1e2e2.
  17. Wang H, Wei X, Liu P, et al. Quality of life and complications at the different stages of bone transport for treatment infected nonunion of the tibia. Medicine (Baltimore) 2017;96(45):e8569. DOI: 10.1097/MD.0000000000008569.
  18. Reitenbach E, Rödl R, Gosheger G, et al. Deformity correction and extremity lengthening in the lower leg: comparison of clinical outcomes with two external surgical procedures. Springerplus 2016;5(1):2003. DOI: 10.1186/s40064-016-3666-3.
  19. Nishio S, Fukunishi S, Fukui T, et al. Comparison of continuous femoral nerve block with and without combined sciatic nerve block after total hip arthroplasty: a prospective randomized study. Orthop Rev (Pavia) 2017;9(2):7063. DOI: 10.4081/or.2017.7063.
  20. Davies AR, Qare JE. Involving consumers in quality of care assessment. Health Aff (Millwood) 1988;7(1):33–48. DOI: 10.1377/hlthaff.7.1.33.
  21. Persico F, Varges O, Fletscher G, et al. Treatment of extraarticular knee extension contracture secondary to prolonged external fixation by a modified Judet quadricepsplasty technique. Strat Trauma Limb Reconstr 2018;13(1):19–24. DOI: 10.1007/s11751-017-0302-x.
  22. Monni T, Birkholtz FF, Lange DP, et al. Conversion of external fixation to internal fixation in a non-acute, reconstructive setting: a case series. Strat Trauma Limb Recon 2013;8(1):25–30. DOI: 10.1007/s11751-013-0157-8.
  23. Vitale MA, Choe JC, Sesko AM, et al. The effect of limb length discrepancy on health-related quality of life: is the ’2cm-rule’ appropriate? J Pediatr Orthop 2006;15(1):1–5. DOI: 10.1097/01202412-200601000-00001.
  24. Abulaiti A, Yilihamu Y, Yasheng T, et al. The psychological impact of external fixation using the Ilizarov or Orthofix LRS method to treat tibial osteomyelitis with a bone defect. Injury 2017;48(12):2842–2846. DOI: 10.1016/j.injury.2017.10.036.
  25. Bullens PH, Loon VCJ, Waal MMC, et al. Patient satisfaction after total knee arthroplasty: a comparison between subjective and objective outcome assessments. J Arthroplasty 2001;16(6):740–747. DOI: 10.1054/arth.2001.23922.
  26. Landge V, Shibata L, Gesheff M, et al. Patient satisfaction after limb lengthening with internal and external devices. J. Surg Orthop Adv 2015;24(3):174–179. DOI: 10.1007/s11420-017-9596-y
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