Factors affecting functional outcome of Sichuan-earthquake survivors with tibial shaft fractures: a follow-up study.

OBJECTIVE The aim of this study was to analyse the various factors affecting functional recovery of earthquake survivors with tibial shaft fractures in Sichuan, China, and to provide a clinical reference for the future management of people injured in earthquakes. METHODS A total of 174 earthquake survivors with tibial shaft fractures were investigated using a face-to-face survey 15 months after the earthquake. Functional recovery after fracture was evaluated by Johner-Wruhs' criteria. Thirteen of the parameters that may influence functional recovery after fracture were included. Univariate and multiple stepwise logistic regression analyses were employed. RESULTS Functional recovery was positively associated with rehabilitation intervention (odds ratio 5.3 (95% confidence interval 2.38-11.67)), but negatively correlated with the immobilization duration (odds ratio (per 10 days increase) 0.87 (95% confidence interval 0.798-0.947)), age (odds ratio (per 10 years increase) 0.54 (95% confidence interval 0.418-0.707)) and depressive symptomatology (odds ratio 0.21 (95% confidence interval 0.063-0.716)). CONCLUSION Functional recovery of post-earthquake survivors with tibial shaft fractures is related mainly to availability of rehabilitation intervention, duration of immobilization, post-earthquake depressive symptomatology, and age. These results may support the future development of strategies for optimizing functional recovery of survivors with lower limb fracture after massive natural disasters.