How Acute Postoperative Pain Impacts Patient Satisfaction After Lower Limb Fracture Surgery: A 14-Day Follow-Up Study

Postoperative pain following lower limb fracture surgery is frequently severe, yet the correlation between this acute pain trajectory and patient satisfaction with care remains poorly understood. This study investigated whether effective early pain relief correlates directly with improved patient satisfaction within the first 14 postoperative days.

A prospective, longitudinal observational study was conducted on 58 adult patients undergoing surgical fixation for lower limb fractures. Pain levels (visual analog scale, VAS) and patient satisfaction (five-point Likert scale) were assessed at two timepoints: 48 hours and 14 days post-surgery.

Mean VAS scores demonstrated a significant reduction from 8.88 ± 0.87 at 48 hours to 4.28 ± 1.1 by day 14 (p value <0.001). Despite initial widespread dissatisfaction, with only one patient (1.7%) satisfied at 48 hours, overall patient satisfaction increased steeply to 52 patients (89.7%) by day 14. Univariate analysis revealed that the type of anesthesia, method of primary analgesia (epidural vs. intravenous), or demographic factors were not significant predictors of patient satisfaction, while the type of fracture fixation (internal vs. external) significantly affected the outcome (p value <0.05).

These findings indicate that pain reduction alone does not exclusively drive satisfaction. Instead, satisfaction appears to be heavily influenced by the type of fixation, effective perioperative communication, and the patient's psychological adaptation over time. However, the association found between fixation type and satisfaction could be highly confounded by underlying fracture severity. Prioritizing patient education may be more effective than focusing solely on absolute pain scores for enhancing the patient experience. The complexity and sequelae of the initial trauma may be the key drivers of long-term patient dissatisfaction rather than the choice of anesthesia/analgesia.