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Patient experience of long-term recovery after open fracture of the lower limb: a qualitative study using interviews in a community setting
  1. Sophie Rees1,
  2. Elizabeth Tutton2,
  3. Juul Achten2,
  4. Julie Bruce1,
  5. Matthew L Costa2
  1. 1 Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
  2. 2 NDORMS, University of Oxford, Oxford, UK
  1. Correspondence to Elizabeth Tutton; liz.tutton{at}ndorms.ox.ac.uk

Abstract

Objectives Treatment of open fractures is complex and patients may require muscle and skin grafts. The aim of this study was to gain a greater understanding of patient experience of recovery from open fracture of the lower limb 2–4 years postinjury.

Design A phenomenological approach was used to guide the design of the study. Interviews took place between October 2016 and April 2017 in the participants’ own homes or via telephone.

Setting England, UK.

Participants A purposive sample of 25 patients were interviewed with an age range of 26–80 years (median 51), 19 were male and six female, and time since injury was 24–49 months (median 35 months).

Results The findings identified a focus on struggling to recover as participants created a new way of living, balancing moving forward with accepting how they are, while being uncertain of the future and experiencing cycles of progress and setbacks. This was expressed through three themes: (i) ‘being disempowered’ with the emotional impact of dependency and uncertainty, (ii) ‘being changed’ and living with being fragile and being unable to move freely and (iii) ‘being myself’ with a loss of self, feeling and looking different, alongside recreation of self in which they integrated the past, present and future to find meaningful ways of being themselves.

Conclusion This study identified the long-term disruption caused by serious injury, the hidden work of integration that is required in order to move forward and maximise potential for recovery. Supportive strategies that help people to self-manage their everyday emotional and physical experience of recovery from injury are required. Research should focus on developing and testing effective interventions that provide support and self-management within a holistic rehabilitation plan.

Trial registration number Current Controlled Trials ISRCTN33756652; Post-results.

  • qualitative research
  • orthopaedic & trauma surgery
  • rehabilitation medicine

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • SR and ET are joint first authors.

  • Contributors SR and ET contributed equally to this paper. The design, data collection, analysis and drafting of the paper were jointly undertaken by SR and ET. As a team, JA, JB and MLC supported the project and were involved in discussion of the findings and the development of this paper.

  • Funding This work was supported by the UK National Institute for Health Research, Health Technology Assessment (HTA) Programme (project number 10/57/20) and was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Centre.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The project was given ethical approval by West Midlands Coventry and Warwickshire Research Ethics Committee (REC Reference: 12/WM/0001) in June 2016.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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