Patient experiences of an ankle fracture and the most important factors in their recovery: a qualitative interview study

Abstract

ObjectiveThe objective of this qualitative research study is to explore patient experiences of ankle fracture and the factors most important to them in recovery.DesignSemistructured interviews exploring patient experiences of ankle fracture recovery at 16–23 weeks following injury. Interviews followed a topic guide and were recorded with an encrypted audio recorder and then transcribed verbatim. Thematic content analysis was used to identify themes in the data.SettingIndividuals were recruited from a sample of participants of a UK-based clinical trial of immobilisation methods for ankle fracture (ISRCTN15537280 at the pre-results stage at time of writing). Interviews were conducted at the participants’ own homes or on a university campus setting.ParticipantsA purposive sample was used to account for key variables of age, gender and fracture management. Participants recruited from the clinical trial sample were adults aged 18 years or over with a closed ankle fracture.ResultsTen participants were interviewed, five of whom were female and six of whom needed an operation to fix their ankle fracture. The age range of participants was 21–75 years with a mean of 51.6 years. Eight themes emerged from the data during analysis; mobility, loss of independence, healthcare, psychological effects, social and family life, ankle symptoms, sleep disturbance and fatigue, and activities of daily living. Factors of importance to participants included regaining their independence, sleep quality and quantity, ability to drive, ability to walk without walking aids or weight-bearing restrictions, and radiological union.ConclusionsThe results of this research demonstrates the extensive impact of ankle fracture on individuals’ lives, including social and family life, sleep, their sense of independence and psychological well-being. The results of this study will enable an increased understanding of the factors of relevance to individuals with ankle fracture, allowing collection of appropriate outcomes in clinical studies for this condition. Ultimately these results will help formulate appropriate patient-centred rehabilitation plans for these patients.Trial registration numberISRCTN15537280; Pre-results

Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial

“…1 2 4 The qualitative impact on individuals is substantial, affecting family and social life, sleep, sense of independence, and psychological wellbeing. 5 Conventionally, after fracture the ankle is immobilised in a rigid cast for several weeks, which allows the bones to heal but can result in joint stiffness and muscle weakness. 6 An alternative is a removable brace, which can be taken off to allow early movement.…”

“…Affected adults are unable to engage in usual physical activities for prolonged periods 124. The qualitative impact on individuals is substantial, affecting family and social life, sleep, sense of independence, and psychological wellbeing 5…”

An evaluation of the measurement properties of the Olerud Molander Ankle Score in adults with an ankle fracture

“…For example, if a person has poor ankle function, this could cause reduction in activity and social participation which could result in symptoms of anxiety and depression. Indeed, research shows that symptoms of anxiety and depression can affect individuals who have sustained an ankle fracture [26,27]. However, these results show a low association between these two scores, indicating that OMAS is not capturing this domain which can affect this population.…”

Principles and guidelines in the management of ankle fractures in adults

“…It is especially important to be vigilant for postoperative complications amongst the elderly due to a high incidence of comorbidities and poor bone quality (Srinivasan & Moran 2001). Complications may include deep vein thrombosis and pulmonary embolism secondary to postoperative immobilisation and casting (Mehta et al 2014). Thromboprophylaxis should therefore be initiated in accordance with local guidelines, and early mobilisation should be considered where appropriate as discussed below (BOA 2016).…”