Structural and physical-functional deficits in lower limbs with fractures and treated surgically

Abstract

Introduction:A fracture is a traumatic bone injury that can occur from a variety of causes. Although the repercussions of fractures on the musculoskeletal system are documented, studies with more comprehensive outcomes and later stages of injury are still scarce. Objective: To evaluate the structural and physicalfunctional adaptations in individuals who suffered unilateral lower limb fractures treated surgically. Methods: Thirty-two patients of both genders, aged between 18 and 59 years, with a diagnosis of unilateral *MAFOfracture of the lower limb and hospital discharge of at least one year, participated in the study. The affected lower limb was compared to the healthy lower limb of all participants using the outcome measures: vastus lateral muscle thickness (ultrasonography), knee extension and flexion strength (isokinetic dynamometer), ankle dorsiflexion range of motion of the distance from the foot to the wall) and functional fitness of the lower limb (single and triple horizontal jump test). Results: Statistically significant differences were found between the limbs affected and not affected in the measurements of muscle thickness (p = 0.0001), knee extension force (p = 0.0094), dorsiflexion amplitude (p = 0.0004) and functional performance (p = 0.0094, single jump and = 0.0114, triple jump). In all significant outcomes, the values of the affected limb were smaller than that of the non-affected limb. The peak torque of the knee flexor muscles did not show a statistically significant difference between limbs (p = 0.0624). Conclusion: Individuals who have undergone a surgically treated unilateral fracture of the lower limb present important structural and physical-functional late changes in relation to the non-affected limb.Introdução: Fratura é uma lesão traumática sofrida pelo osso que pode ocorrer por causas diversas. Embora as repercussões das fraturas sobre o sistema musculoesquelético sejam documentadas, estudos com medidas desfecho mais abrangentes e em fases mais tardias da lesão ainda são escassos. Objetivo: Avaliar as adaptações estruturais e físico-funcionais em indivíduos que sofreram fratura unilateral de membro inferior tratadas cirurgicamente. Métodos: Participaram do estudo 32 pacientes de ambos os sexos, com idade entre 18 e 59 anos, com diagnóstico de fratura unilateral de membro inferior e alta hospitalar de no mínimo 1 ano. O membro inferior acometido foi comparado ao membro inferior saudável de todos os participantes utilizando as medidas de desfecho: espessura muscular do vasto lateral (ultrassonografia), força de extensão e flexão do joelho (dinamômetro isocinético), amplitude de movimento de dorsiflexão do tornozelo (teste da distância do pé à parede) e aptidão funcional do membro inferior (teste de salto horizontal simples e triplo). Resultados: Foram encontradas diferenças estatisticamente significativas entre os membros acometidos e não acometidos nas medidas de espessura muscular (p = 0,0001), força de extensão do joelho (p = 0,0094), amplitude de dorsiflexão (p = 0,0004) e desempe...

Assessment of Functional Limitation and Associated Factors in Adults with Following Lower Limb Fractures, Gondar, Ethiopia in 2020: Prospective Cross-Sectional Study

“…This result is slightly consistent with the cross-sectional study done in the USA – which consisted of a sample of 509 participants aged between 15 and 65 years – reported that the level of functional activity was 75%. 11 However, our result was considerably higher compared to other studies, which reported 45% in Brazil; 4 65% in Maryland, USA. This variation in the current study can be explained by the age range of the study participants in current study was between 18–85 while a study done in Maryland among 302 participants with mean age of 34 years.…”

“…More than 90% of traumatic morbidity, mortality, and associated disability related to fractures occurs in low and middle income countries (LMIC). 3 , 4 Different studies reported that the cause of fractures in LMIC was road traffic accidents, personal conflict, interpersonal violence, and work related accidents. 5 , 6 Based on body parts involved; lower extremity, head and hand, multiple part and upper extremity were commonly reported types of fracture.…”

“…Because of the complication of treatment and lack of early rehabilitation, patient faced reduction of body composition and physical function like muscular and bone hypotrophy, ligament and capsular retraction, pain, joint stiffness, poor circulation, mobility limitation, risk of falls, loss of independent activity of daily living (ADL), limited range of motion (ROM) and decreased muscle strength. 4 , 11 …”

“…After a fracture of the lower extremity, the duration of immobility of the affected limb and the time of hospitalization may negatively influence the body composition and the physical function of the patients. 4 The lower limb fractures complications are one of the major reason for hospital stay and have high impact on the rehabilitations services. Functional limitations related to lower extremities fractures which are related to the decreased functional mobility require long term use of assistive devices, lack of independence, and the long term need for assistive care.…”