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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2004 December;55(6):227-37
language: English, Italian
Quality of life evaluation in patients treated with external fixation for pseudoarthrosis of the long bones
Zoccola K. 1, Chiavola M. 1, Pazzano S. 1, Massè A. 2, Aloj D. 2
1 Orthopedic Traumatologic Center Department of Traumatology Orthopedics and Occupational Medicine University of Turin, Turin, Italy
2 CTO/CRF Maria Adelaide Hospital, Turin, Italy
Aim. Nowadays, one of the most important developments in sanitary assistance is the recognition of the crucial role of the patient’s point of view as to the quality of life in evaluating medical care results. The authors present a long term follow-up study on the quality of life appraised in patients treated with external fixation for pseudoarthrosis of the tibia or femur. The aim of this study is to assess the quality of life referred by the patient as part of a further evaluation variable of the results when evaluating the effectiveness and appropriateness of the operation.
Methods. A total of 61 subjects were enrolled into the study after an average interval of 10 years from the first treatment. All subjects had been treated with external fixation for pseudoarthrosis of the tibia or femur between 1982 and 1999. Two types of questionnaire were used to collect data: 1) a general health questionnaire — SF-36; 2) a specific questionnaire — WOMAC, which were filled in by a physician using telephone interviews. The scores were correlated with the type of pseudoarthrosis, treatment/pre-treatment and how long they lasted, year of the treatment and patient’s age. The results were divided according to the site affected by pseudoarthrosis i.e. femur or tibia and compared one with the other. A comparison with the healthy Italian population was possible only for the SF-36 questionnaire, as the Italian version of the WOMAC questionnaire is still being validated.
Results. No statistically significant difference between the pseudoarthrosis site (tibia/femur) in the final scores of the SF-36 and WOMAC questionnaires was observed. Comparison with the Italian standard population showed the biggest limitations to be the physical component. Patients treated for tibia pseudoarthrosis had a higher average statistically significant score when compared to the normal score in the health-scale. Patients treated for femur pseudoarthrosis had a lower score compared to the normal population in the evaluation of social activities. A statistically significant correlation was observed between the WOMAC pain scale and the patient’s age. There was an inverse correlation between the year of surgery and the SF-36 score when evaluating the general state of health.
Conclusion. The subjects under examination had a good subjective opinion of their own general health. Some limitations in physical activity were noted when compared to the standard population. There was no significant difference in the emotional or behavioral state compared to the norm.