Evaluation of remote results of treatment of children with long-bone fractures of the lower extremities

Abstract

Background. Evaluation of the effectiveness of treatment of long-bone fractures of the lower extremities should be comprehensive and include both subjective and objective indicators. In the developed countires, it is standard to assess the quality of life related to children’s health after trauma. According to the Russian literature, such assessment has not been studied. The aim of our study was to assess the quality of life in children, with long-bone fractures of the lower extremities, and to compare the results with data from the Lower Extremity Functional Scale (LEFS) and assessment system according to N.B. Duysenov.Materials and methods. We examined 70 patients (age range, 8–18 years) with long-bone fractures of the lower extremities. Forty patients had a history of tibia fracture, and 30 patients had a history of femoral fracture. We determined the severity of the fractures using pediatric comprehensive classification of long-bone fractures (PCCF). We assessed the quality of life of the children using the Pediatric Questionnaire for Quality of Life (PedsQLTM 4.0).Results. Trauma had a significant impact on the quality of life in children. The children evaluated their quality of life after injury more objectively; on all scales, their scores had the highest correlation with LEFS and assessment system according to N.B Duysenov. In most cases, parents underestimated the mental and physical burden of their child’s condition after injury. The values for the “physical functioning” assessment in children with severe trauma was the lowest, and was not significantly different between parents and children. Parents who were aware of the severity of the injury gave their child more attention, which positively affected the child’s psychological and social functioning. Children with severe trauma had higher values on the emotional, social and role functioning scale, compared to children with minor injuries.Conclusions. The results of all functional scales in the quality of life assessment, as assessed by the children themselves at different times after injury, had the highest correlation with LEFS and assessment system according to N.B. Duysenov. LEFS is the most informative for examining the consequences of fractures of different severity. There were no significant differences among the children with fractures of varying severity using the assessment system according to N.B. Duysenov.