Factors Related to Lower-Limb Functional Recovery in Persons with Closed Fracture of Femur Undergoing Internal Fixation Surgery
Main Article Content
Abstract
This descriptive study aimed to describe lower-limb functional recovery and examine the relationship between the type of internal fixation, illness perception,rehabilitation behavior, and social support with lower-limb functional recovery in persons with closed fracture of femur after undergoing internal fixation surgery for three months. Sampling technique was determined by the period of time based on the inclusion criteria was used to recruit a sample of 90 persons with closed fractures of the femur undergoing internal fixation surgery for three months who visited the orthopedic outpatient department of the hospital under the Ministry of Public Health from August 2021 to October 2022. Research instruments included the Demographic Questionnaire, the Brief Illness Perception Questionnaire, the Rehabilitation Behavior Questionnaire, the Social Support Questionnaire,and the Modified Lower Extremity Functional Scale. Descriptive statistics, independent t-test, and Pearson’s product moment correlation were employed for data analyses. The results showed that 40.20% of the sample had lower-limb functional recovery. The mean lower-limb functional recovery score was at a moderate level.Statistical analysis revealed that illness perception and social support were significantly negatively correlated with lower-limb functional recovery. Rehabilitation behavior in patients was significantly positively correlated with lower-limb functional recovery. In addition, lower-limb functional recovery in patients who received internal fixation surgery with plate and nailing was not significantly different. The results of the study suggest that illness perception should be assessed. Continuous education and training in rehabilitation skills for patients after internal fixation surgery are needed to achieve bone recovery. Moreover,providing knowledge to relatives in caring for and encouraging patients to have appropriate and effective rehabilitation behavior is also needed to accomplish full bone recovery.
Keywords: Illness perception, Lower-limb functional recovery, Rehabilitation behaviors,Social support, Type of internal fixation
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
References
MinistryofPublic Health. Reportof illness. 2021. [cited2023 May 20]. Available from: https://spd.moph.go.th/wp-content/ uploads / 2023/04/ill_2021_full_280921_V2-64.pdf (in Thai)
BuecheleG,BeckerC,CameronID,AuerR,Rothenbacher D, König HH, et al. Fracture risk in people with developmental disabilities: results of a large claims data analysis. Osteoporos Int. 2017;28:369-75. doi.org/10.1007/s00198-016-3733-1.
Pimentel L. Orthopedic trauma: office management of major joint injury.Med Clin North Am.2006;90(2):355-82.doi.org/ 10.1016/ j.mcna.2005.11.004.
Pradeep AR, KiranKumar A, Dheenadhayalan J,RajasekaranS. Intraoperative lateral wall fractures during dynamic hip screw fixation for intertrochanteric fractures-Incidence. Injury. 2018;49(2):
Palakai R. Rehabilitation. 2024. [cited 2024 July 11].Available from:https://tpak.or.th/th/article_print/231(in Thai)
Bell A, Templeman D, Weinlein JC. Nonunion of the femur and tibia: an update. Orthop Clin North Am.2016;47(2):365-75. doi.org/ 10.1016/j.ocl.2015.09.010.
CostaML, AchtenJ, GriffinJ,PetrouS,Pallister I, Lamb SE,etal. Effect of locking plate fixation vs intramedullary nail fixation on 6-month disability among adults with displaced fracture of the distal tibia: the UK fixDT randomized clinical trial.JAMA.2017;318(18):1767-76.doi:10.1001/jama.2017.16429.
Loosen A,Fritz Y,DietrichM.Surgical treatment of distal femur fractures in geriatric patients. Geriatr Orthop Surg Rehabil. 2019;10:1-5. doi.org/10.1177/2151459319860723.
Zura R, MehtaS, Della Rocca GJ,Steen RG. Biological risk factors for nonunion of bone fracture. JBJS Rev.2016;4(1):1-12.doi:10.2106 / JBJS.RVW.O.00008.
Purivatanakul N, Tipmongkol V, Wongleang K. Effects of a telephone education program on self-care behavior for rehabilitative fractured femur patients.Songklanagarind Medical Journal. 2007;25(1):19-27. (in Thai)
Hadeed MM, Kandil A, Patel V, Morrison A, Novicoff WM,Yarboro SR.Factors associated with patient-initiated telephone calls after orthopedic trauma surgery. J Orthop Trauma. 2017;31(3):e96-e100. doi: 10.1097/BOT.0000000000000746.
Córcoles-Jiménez MP, Villada-Munera A, del EgidoFernández MÁ, Candel-Parra E, Moreno-Moreno M,Jiménez-Sánchez MD,et al. Recovery of activities of daily living among older people one year after hip fracture. Clin Nurs Res. 2016;24(6):604-23.doi:10.1177/10547
Mukpradab S,Songwathan P,Sea-sia W. An outcome-oriented movement-supporting program and its musculoskeletal outcomes as observed in trauma patients suffering from immobilization:apilotstudy. Thai Journal of Nursing Council. 2014;29(2):49-60. (in Thai)
Chaiwanichsiri D, Kitisomprayoonkul W. Rehabilitation medicine textbook. 3rded. Bangkok: Chulalongkorn University Printing House; 2013. (in Thai)
LiskaF, Haller B, Voss A,Mehl J, Imhoff FB,Willinger L,etal.Smoking and obesity influence the risk of nonunion in lateral opening wedge,closing wedge and torsional distal femoral osteotomies. Knee Surg Sports Traumatol Arthrosc. 2018;26(9):2551-57. doi.org/ 10.1007/s00167-017-4754-9.
Archer KR, Castillo RC, Mackenzie EJ, Bosse MJ. Gait symmetry and walking speed analysis following lower-extremity trauma.Phys Ther. 2006;86(12):1630-40.doi.org/10.2522/ptj.20060035.
Vincent HK, Horodyski M, Vincent KR, Brisbane ST,Sadasivan KK. Psychological distress after orthopedic trauma: prevalence in patients and implications for rehabilitation. PM R. 2015;7(9):978-89. doi.org/10.1016/j.pmrj.2015.03.007.
Kellezi B, Coupland C, Morriss R, Beckett K, JosephS,Barnes J, et al. The impact of psychological factors on recovery from injury: a multicentre cohort study.Soc Psychiatry Psychiatr Epidemiol. 2017;52(7):855–66.doi.org/10.1007/s00127-016-1299-z.
Meleis AI. Transition theory:middle-range and situation-specific in nursing research and practice. Nurs Outlook.2010;64(2):186-96.
Weng S, Bi C, Gu S, Qi X, Huang Y. Immediate weightbearing after intramedullary fixation of extra-articular distal tibial fractures reduces the nonunion rate compared with traditional weight-bearing protocol: a cohort study. Int JSurg. 2020;76:132-35.doi.org/10.
/j.ijsu.2020.02.040.
Bisaccia M, Cappiello A, Meccariello L, Rinonapoli G,Falzarano G, Medici A, et al. Nail or plate in the management of distal extra-articular tibial fracture, what is better? valutation of outcomes.SICOT-J. 2018;4:2.doi: 10.1051/sicotj/2017058. Epub 2018 Feb 21.PMID: 29469802;PMCID:PMC5822878.
Hoyt BW,Pavey GJ,Pasquina PF,Potter BK.Rehabilitation of lower extremity trauma: a review of principles and military perspective on future directions.Curr Trauma Rep.2015;1:50-60. doi.org/10.1007/s40719-014-0004-5.
Damman W, Liu R, Kaptein AA, Evers AW, van Middendorp H, Rosendaal FR, et al. Illness perceptions and their association with 2 year functional status and change in patients with hand osteoarthritis. J Rheumatol.2018;57(12):2190-99. doi.org/10.1093/ rheumatology / key231.
Xu B, Chen L, LeeJH.Smoking and alcohol drinking and risk of non-union or delayed union after fractures: a protocol for systematic review anddose–response metaanalysis. Medicine. 2020;99(5):1-6. doi.10.1097/MD.0000000000018744.
Weimert S, Kuhn S, Rommens PM, Beutel ME, Reiner IC.Symptoms of adjustment disorder and smoking predict long-term functional outcome after ankle and lower leg fracture. J Rehabil Med. 2020;52(8):1-8.
Phelps EE, Tutton E,GriffinX,BairdJ.A qualitative study of patients’ experience of recovery after a distal femoral fracture. Injury. 2019;50(10):1750-5. doi.org/10.1016/j.injury.2019.07.021.
Sleney J, Christie N, Earthy S, Lyons RA, Kendrick D,Towner E. Improving recovery learning from patients’experiences after injury: a qualitative study. Injury.2014;45(1):312-9.doi.org/10.1016/j.injury.2012.12.025.
Thepphawan P,Watthnakitkrileart D,Pongthavornkamol K, Dumavibhat C. Cognitive representation, emotional responses and hospitalization experience in predicting decision making for receiving treatment among patients with acute coronary syndrome.Journal of Nursing Science.2011;29(2):111-9. (in Thai)
Sanee N,PreechawongS, Limthongkul W. The effect of perceivedself-efficacy promoting program on rehabilitation behavior among patients having internal fixation of fractured femur.Journal of Nursing Science Chulalongkorn University. 2014;26(2):122-34. (in Thai)
Chaipinyo K, Khoprasert W, Likhitphithak W,Pareepon A. Test-retest reliability of modified Thai lower extremity functional scale (Modified Thai LEFS)and correlation to Thai version of knee osteoarthritis outcome scores (Thai KOOS), self-pace walk test (SPWT), and timed up and go test (TUG) in Thais with knee osteoarthritis. Thai Journal of Physical Therapy. 2018;40(3):134-45(in Thai)
Gabel CP. The lower extremity functional scale(LEFS):evidence of factorial validity, responsiveness, and reliability. J Orthop Sports Phys Ther.2014;44(11):798-807.
RuderJA,HartGP,KneislJS,Springer BD,&Karunakar MA. Predictors of functional recovery following periprosthetic distal femur fractures. J Arthroplasty.2017;32(5):1571-5. doi.org/10.1016/j.arth.2016.12.013.
Wu KJ, LiSH, Yeh KT, ChenIH, Lee RP, Yu TC, et al.The risk factors of nonunion after intramedullary nailing fixation of femur shaft fracture in middle age patients.Medicine.2019;98(29):1-6.doi: 10.1097/MD.0000000000016559.
Phusunti S, Suthutvoravut W, Unnanuntana A,Chotiyarnwong P. The prevalence of hypovitaminosis D in patient with fragility hip fracture at a single institution in Thailand. Journal of the Medical Association of Thailand. 2016;99(11):1233-8. (in Thai)
Gortler H,Rusyn J,Godbout C,Chahal J,Schemitsch EH,Nauth A.Diabetes and healing outcomes in lower extremity fractures: a systematic review.Injury.2018;49(2):177-83.doi.org/10.1016/j.injury.2017.11.006.
Fors M,Öberg B, Enthoven P,Schröder K,AbbottA. The association between patients’ illness perceptions and longitudinal clinical outcome in patients with low back pain. Pain Rep. 2022;7(3):1-7. doi: 10.1097/PR9.0000000000001004.
Kardosod A. Postoperative care for intertrochanteric fracture patients undergoing open reduction and internal fixation(ORIF). Nursing Journal ChiangMai University.2019;46(4):183-92. (in Thai
Phuphaibul R, Jongudomkarn D, Nieamsup T, Tejagupta C, & Kumhom R. Structural changes in Thai families.Journal of Demography. 2018;34(1):43-53.(in Thai)
Griffiths F,Mason V, BoardmanF, Dennick K, Haywood K, Achten J, et al. Evaluating recovery following hip fracture:a qualitative interview studyof what is important topatients.BMJOpen. 2015;5(1):1-10.doi:10.1136/bmjopen-2014-005406.
Tank JC,Schneider PS, Davis E, Galpin M,Prasarn ML,Choo AM, et al. Early mechanical failures of the synthes variable angle locking distal femur plate.JOrthop Trauma.2016;30(1):7–11. doi: 10.1097/BOT.0000000000000391.
Van der Vusse M, Kalmet PHS, Bastiaenen CHG, van Horn YY, BrinkPRG,Seelen HAM. Is the AO guideline for postoperative treatment of tibial plateau fractures still decisive? A survey among orthopedic surgeons and trauma surgeons in the Netherlands. Arch Orthop Trauma Surg.2017;137(8):1071-5. doi.org/10.1007/s00402-017-2718-7.