A preliminary analysis of early patient-reported return to normal and pain after lower extremity fracture surgery

To objectively evaluate the early subjective recovery of patients undergoing lower extremity fracture surgery.

A retrospective review at a level one trauma center of patients undergoing lower extremity fracture surgery. The Percent of Normal (PON) single assessment numerical evaluation and average pain scores were collected at each follow-up. Scores at 2, 6, 12, and 24-weeks were analyzed and compared between fracture types.

There were 292 patients included. The median age was 39.0 years (IQR 28.0 to 58.0) and 55.1% (n =  161) were male. Fractures were caused by high-energy mechanisms in 52.7% (n =  154) and 11.3% (n =  33) were open. The median PON and pain scores at the 2, 6, 12, and 24-week follow-up visits were 40%, 60%, 70%, and 80% and 4.0, 2.0, 2.0, and 2.0, respectively, and did not differ by fracture type (p >  0.05). Patients who had unplanned reoperations (n =  17), compared to those who did not, had longer follow-up (12.4 vs 4.0 months, p <  0.0001) and were similar in age, gender, high energy mechanisms, open fractures, and OTA/AO fracture types (p >  0.05). At last follow-up, patients who had unplanned reoperations had lower PON scores (60.0% vs. 75.0%, p =  0.03).

Twenty-four weeks after lower extremity fracture surgery patients reported a median PON score of 80% and a pain score of 2.0. Unplanned reoperations significantly decreased PON scores at last follow-up. This preliminary analysis may be useful for counseling patients on the general recovery timeline after fracture surgery and informing future studies.

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