Patient-Reported Outcomes After Distal Femur Fracture Fixation: A Retrospective Cohort Study of 151 Patients

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Patient-Reported Outcomes

Background:

• Distal femur fractures are severe injuries requiring operative treatment.
• Assessing long-term functional recovery is crucial for patient management.
• Patient-Reported Outcomes Measurement Information System (PROMIS) provides validated functional metrics.

Purpose of the Study:

• To evaluate Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF), Global Health Physical (GH-Physical), and Global Health Mental (GH-Mental) scores at 6, 9, and 12 months postoperatively.
• To identify factors associated with physical function recovery after operative treatment of distal femur fractures.

Main Methods:

• Retrospective cohort study at two Level 1 Trauma Centers.
• Included adult patients with operatively treated distal femur fractures (AO/OTA 33A or 33C) with PROMIS scores between 3-12 months.
• Mixed-effects linear regression analyzed factors associated with PROMIS-PF scores.

Main Results:

• PROMIS-PF scores improved significantly from 6 to 12 months (34.8 to 37.9; P < 0.001), but remained below US reference (50 points).
• PROMIS-GH-Physical and GH-Mental scores showed no significant change over time.
• Female sex, assisted baseline ambulation, and lower mental health scores were associated with worse physical function outcomes.

Conclusions:

• Physical function after distal femur fracture surgery shows improvement but persistent deficits at 12 months.
• Clinicians should counsel patients on likely long-term physical impairment.
• Baseline functioning and mental health are key predictors of recovery, more so than injury characteristics.