Grade III open tibial fractures - Functional outcome and quality of life in amputees versus patients with successful reconstruction

The purpose of this study was to assess the long-term functional outcome an d the quality of life of patients who were treated for a (Gustilo) Grade II I open tibial fracture. We included 43 patients with successful limb salvage (group A) and 21 amput ees (group B). The groups were similar with regard to age, sex, and Injury Severity Score (ISS). The functional outcome was scored using the 'Guides t o the Evaluation of Permenant Impairment'. To compare quality of life we us ed the Nottingham Health Profile (NHP), the SF-36, and a questionnaire espe cially designed for this study. The mean lower extremity impairment (AMA) of patients in group A was 17.6%, compared to 73.5% for patients in group B. The results with both NHP and S F-36 show that patients in both groups have more problems in most categorie s than a healthy reference group. With the NHP, the difference in score was largest for the categories of pain, mobility, energy and sleep. The SF-36 scores correlated well with the NHP scores. No significant difference was f ound between the two groups. This type of injury has an enormous impact on every aspect of life - irresp ective of the chosen treatment. A significant difference in lower extremity impairment is found between patients with a successful reconstruction and those who are amputees. However, the quality of life was shown to be the sa me. (C) 2001 Elsevier Science Ltd. All rights reserved.