Rehabilitation: Long-Term Outcome and Quality of Life

Well-designed clinical research remains necessary in order to evaluate the quality of care in trauma patients with lower extremity fractures. A critical assessment of the orthopedic trauma outcome literature requires a critical review of the study validity, numerical results, and the actual implications for the clinical practice. This chapter summarizes the pertinent outcomes in polytrauma patients with extremity fractures. With increased survival rates of polytrauma patients over the last decade, long-term functional outcomes have gained importance. Recent studies have shown that lower extremity fractures seem to significantly impact the functional recovery of polytrauma patients. In particular, distal lower extremity fractures as well as upper extremity nerve injuries seem to be associated with significant long-term disability and limit the functional recovery. Although it still remains unclear which particular subset of patients may benefit from limb salvage versus amputation, recent research has emphasized on certain patient factors, such as patient self-efficacy, age, race, education level, smoking, pre-injury employment, and litigations, having a significant impact on patient recovery regardless of the treatment rendered. Yet, utilizing reliable and validated measurement tools is imperative to help improve the quality of long-term trauma-specific outcomes.