The relationship between gait and functional outcomes in patients treated with circular external fixation for malunited tibial fractures.
Circular external fixation
Complex trauma
Gait analysis
Patient reported outcome measures (PROMs)
Tibial malunion
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
25
09
2018
revised:
21
12
2018
accepted:
06
01
2019
pubmed:
15
1
2019
medline:
16
4
2019
entrez:
15
1
2019
Statut:
ppublish
Résumé
Lower extremity fractures have a profound negative effect on a patient's gait and outcomes. Correction of deformity, and with it normalization of objective gait parameters, may result in better subjective and objective functional outcomes in patients treated with circular external fixation for malunited tibial fractures. The purpose of this study was to investigate the relationships between gait parameters, patient reported outcome measures (PROMs), and health related quality of life measures in patients treated with circular external fixation for the correction of deformity related to tibial malunions. This retrospective study included patients with posttraumatic tibial deformities, aged 14-65, with a minimum follow-up of 24 months following deformity correction. Patients with congenital deformities, head injuries, spinal cord injury, neurological disorders, or contralateral lower limb amputation were excluded. Functional outcomes were assessed by the Foot Function Index (FFI); Short Form 12 (SF-12); the EQ 5D; and the ASAMI score. Gait analysis was performed using Dartfish® and the Edinburgh Visual Gait Score (EVGS). The relationships between the EVGS and functional outcome scores were analyzed using Pearsons' moment correlations with Bonferroni corrections. Eleven patients with a mean age of 42 (range 23-57) were analyzed. The mean EVGS was 2.6 ± 2.1, the mean FFI 29.6 ± 33.4, the mean EQ5 Index Value 0.7 ± 0.2, the mean EQ5 VAS 85.4 ± 19.5, the SF12 mean Physical Component Score (PCS) 46.7 ± 11.1, and the mean Mental Component Score (MCS) 55.2 ± 7.5. The following relationships were strong and significant: EVGS and FFI (r = 0.7; P = 0.02), EVGS and PCS (r = -0.82; P = 0.02), and FFI and EQ5 (r = -0.79, P = 0.05). The results of this study suggest that correction of deformity with realignment and restoration of normal anatomy was associated with improved functional outcomes and physical well-being. Patient reported quality of life is strongly associated with patient perceived functional outcome, but not with objective gait parameters.
Sections du résumé
BACKGROUND
Lower extremity fractures have a profound negative effect on a patient's gait and outcomes. Correction of deformity, and with it normalization of objective gait parameters, may result in better subjective and objective functional outcomes in patients treated with circular external fixation for malunited tibial fractures.
AIM
The purpose of this study was to investigate the relationships between gait parameters, patient reported outcome measures (PROMs), and health related quality of life measures in patients treated with circular external fixation for the correction of deformity related to tibial malunions.
METHODS
This retrospective study included patients with posttraumatic tibial deformities, aged 14-65, with a minimum follow-up of 24 months following deformity correction. Patients with congenital deformities, head injuries, spinal cord injury, neurological disorders, or contralateral lower limb amputation were excluded. Functional outcomes were assessed by the Foot Function Index (FFI); Short Form 12 (SF-12); the EQ 5D; and the ASAMI score. Gait analysis was performed using Dartfish® and the Edinburgh Visual Gait Score (EVGS). The relationships between the EVGS and functional outcome scores were analyzed using Pearsons' moment correlations with Bonferroni corrections.
RESULTS
Eleven patients with a mean age of 42 (range 23-57) were analyzed. The mean EVGS was 2.6 ± 2.1, the mean FFI 29.6 ± 33.4, the mean EQ5 Index Value 0.7 ± 0.2, the mean EQ5 VAS 85.4 ± 19.5, the SF12 mean Physical Component Score (PCS) 46.7 ± 11.1, and the mean Mental Component Score (MCS) 55.2 ± 7.5. The following relationships were strong and significant: EVGS and FFI (r = 0.7; P = 0.02), EVGS and PCS (r = -0.82; P = 0.02), and FFI and EQ5 (r = -0.79, P = 0.05).
SIGNIFICANCE
The results of this study suggest that correction of deformity with realignment and restoration of normal anatomy was associated with improved functional outcomes and physical well-being. Patient reported quality of life is strongly associated with patient perceived functional outcome, but not with objective gait parameters.
Identifiants
pubmed: 30640157
pii: S0966-6362(18)31637-0
doi: 10.1016/j.gaitpost.2019.01.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
569-574Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.