Functional outcomes of displaced femoral fractures in adults at the University Teaching Hospital in Lusaka, Zambia

Abstract

Functional outcomes in patients with diaphyseal femoral fractures have been found to vary with the severity of the injury. Measuring outcomes is an important component of a physical therapists practice as it is important in the direct management of individual patients and also in comparing and determining effectiveness of management. Careful assessment, diligent planning, meticulous operative techniques and postoperative rehabilitation contributes to good outcomes. There has been very little follow up on how patients carry out their activities of daily living both in the case of those treated non-operatively and operatively after diaphyseal femoral fractures at UTH. Objective was to determine the functional outcomes of patients with diaphyseal femoral fractures managed non-operatively and those managed operatively at the University Teaching Hospital (UTH). A longitudinal study of patients that presented with diaphyseal femoral fractures was carried out at UTH in Lusaka, Zambia. Thirty-two patients were included in the study using purposive sampling technique. A checklist adopted and adapted from the Lower Extremity Functional Scale (LEFS) was used to assess function. Data analysis was done using Statistical Package in Social Science (SPSS) version 20.0 software for windows. The Fishers exact test and Chi-Square test were used to test for associations between independent and dependent variables and to compare the two types of management. Regression analysis was used to test for predictors of functional outcomes. Significance was set at 0.05. The majority of patients (n=84%) that were seen where males. Furthermore, the majority of patients (n=25%) in the study where between the age range of 26 to 30 years. There was found to be a statistical correlation between the male gender and functional outcome (p=0.044). A further correlation was found between age and functional outcomes (p=0.029). The younger you are the better the functional outcomes. It was also found a significant statistical correlation between the cause of the fracture being a gunshot (p=0.017), physiotherapy intervention (p=0.032) and the functional outcomes of the patient after femoral diaphyseal fractures. It was found that there was no significant correlation (p=0.657) between the type of management used and the functional outcomes of the patients with diaphyseal femoral fractures. Residual deficits in function were measurable in patients with diaphyseal femoral fractures 3 months after injury and management. Functional outcomes of diaphyseal femoral fractures are affected by age, gender, physiotherapy intervention and causes of the fracture.