Predictors of lower health-related quality of life after operative repair of diaphyseal femur fractures in a low-resource setting

• Published in: Injury Vol. 49; no. 7; pp. 1330 - 1335
• Main Authors: Ibrahim, John M., Conway, Devin, Haonga, Billy T., Eliezer, Edmund N., Morshed, Saam, Shearer, David W.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-07-2018
• Subjects: Africa; Femur fractures; Low-income; Orthopaedic trauma; Predictors; Quality of life; Tanzania; Femur fractures; Orthopaedic trauma; Low-income; Africa; Tanzania; Quality of life; Predictors
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2018.05.021

Little data exists on the negative impact of orthopaedic trauma on quality of life (QOL) in low- and middle-income countries (LMICs). The goal of this study is to investigate the factors associated with lower QOL after operative fixation of femoral shaft fractures in adult patients in a low-resource setting.
This prospective cohort study followed 272 factures in adults undergoing operative fixation for diaphyseal femur fractures at Tanzania. Patient demographics, injury characteristics, treatment modalities, and functional outcomes up to 1-year post-operatively were evaluated for association with 1-year post-operative EQ-5D QOL scores via univariate linear regression analysis.
EQ-5D values were significantly lower at 1 year than at baseline (0.941 vs 0.991, p < 0.0005).
Operative fixation of femoral shaft fractures in LMICs results in return to near baseline QOL. Demographic and treatment factors were not significantly associated with EQ-5D. and several markers of recovery were associated with lower 1 year QOL, including pain, knee stiffness, delayed radiographic healing, complications requiring reoperation. Efforts to reduce perioperative complications may help improve post-operative QOL.