Aims
Open lower limb fracture is a life-changing injury affecting 11.5 per 100,000 adults each
year, and causes significant morbidity and resource demand on trauma infrastructures. This
study aims to identify what, and how, outcomes have been reported for people following
open lower limb fracture over ten years.
Methods
Systematic literature searches identified all clinical studies reporting outcomes for adults
following open lower limb fracture between January 2009 and July 2019. All outcomes and
outcome measurement instruments were extracted verbatim. An iterative process was used
to group outcome terms under standardized outcome headings categorized using an outcome taxonomy.
Results
A total of 532 eligible studies were identified, reporting 1,803 outcomes with 786 unique
outcome terms, which collapsed to 82 standardized outcome headings. Overall 479 individual outcome measurement instruments were identified, including 298 outcome definitions, 27 patient- and 18 clinician-reported outcome measures, and six physical performance
measures. The most-reported outcome was ‘bone union/healing’ reported in over 50% of
included studies, while health-related quality of life was only measured in 6% of included
studies.
Conclusion
Outcomes reported for people recovering from open lower limb fracture are heterogeneous,
liable to outcome reporting bias, and vary widely in the definitions and the measurement
tools used to collect them. Outcomes likely to be important to patients, such as quality of life
and measures of physical functioning, have been neglected. This systematic review identifies
the need to unify outcome measures reported on patients recovering from open lower limb
fracture; this may be addressed by creating a core outcome set.
This study aims to identify what, and how, outcomes have been reported for people following
open lower limb fracture over ten years.
Alexander L. Aquilina
Henry Claireaux
Christian O. Aquilina
Elizabeth Tutton
Raymond Fitzpatrick
Matthew L. Costa
Xavier L. Griffin
Disease Category: Wounds
Disease Name: Lower limb fracture
Age Range: Unknown
Sex: Either
Nature of Intervention:
- Systematic review of outcomes measured in trials
- Systematic review
The EMBASE and MEDLINE bibliographic databases were searched using Ovid (Ovid Technologies 2020, Wolters Kluwer), and supplemented by PsychINFO, CINHAL, and Cochrane CENTRAL in the English language from 1 January 2009 to 20 April 2017. A search update was made in July 2019 of the EMBASE and MEDLINE databases (see Supplementary Material 1);