Background

Fracture related infection (FRI) of the foot is a serious hazard. Despite successful therapy, the physiological and psychological involvement seems to be high. Therefore, we aim to analyze the impact of an FRI of the foot on the quality of life after successful surgical therapy and infect eradication.

Methods

In total, 25 patients from two German hospitals treated for FRI of the foot between March 2011 to January 2020 were retrospectively included. Quality of life was assessed by the German Short Form 36 (SF-36) and the EuroQol five-dimension three-level questionnaire (EQ-5D) as well as the ICD-10 based psychological symptom rating (ISR), and compared to a norm obtained from the general population of Germany.

Results

3.0 years (range 0.7–7.9 years) following final surgery after fracture-related infection of the foot, the mean physical health component score (PCS) of the SF-36 was 35.6 ± 12.3, and the mean mental health component score (MCS) of the SF-36 reached a value of 41.3 ± 12.9. Both values were significantly lower than in the general population of Germany (p< .019). The mean scores of the ISR of the cohort crossed the threshold of mild symptom burden in total, as well as for the subscales depression and somatization. The mean EQ-5D VAS rating (62.1 ± 18.6) and the EQ-5D index value (0.66 ± 0.27) were significantly lower in comparison to a score of 72.9 ± 1.0 and 0.88 obtained from an age-matched reference population (p < .01).

Conclusion

FRI of the foot represents a major burden for the patient. Physical and mental well-being of affected patients is restricted albeit successful treatment in terms of infect eradication and bone union has been achieved after a mean follow-up of 3.0 years. A patient-centered treatment approach focusing on improvement of quality of life during and after treatment is therefore warranted.

中文翻译：

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足部骨折相关感染后的生活质量

背景

足部骨折相关感染 (FRI) 是一种严重的危害。尽管治疗成功，但生理和心理参与似乎很高。因此，我们旨在分析足部 FRI 对成功手术治疗和感染根除后生活质量的影响。

方法

总共回顾性纳入了 2011 年 3 月至 2020 年 1 月期间来自两家德国医院的 25 名足部 FRI 患者。生活质量通过 German Short Form 36 (SF-36) 和 EuroQol 五维三级问卷 (EQ-5D) 以及基于 ICD-10 的心理症状评分 (ISR) 进行评估，并与从德国普通民众那里获得的标准。

结果

足部骨折相关感染后最后一次手术后 3.0 年（范围 0.7-7.9 年），SF-36 的平均身体健康成分评分 (PCS) 为 35.6 ± 12.3，平均心理健康成分评分 (MCS) SF-36 的值达到 41.3 ± 12.9。这两个值都显着低于德国一般人群 ( p < .019)。该队列的 ISR 平均得分总体上超过了轻度症状负担的阈值，抑郁和躯体化分量表也是如此。平均 EQ-5D VAS 评分 (62.1 ± 18.6) 和 EQ-5D 指数值 (0.66 ± 0.27) 显着低于从年龄匹配的参考人群中获得的 72.9 ± 1.0 和 0.88 的分数 ( p  < . 01).

结论

足部 FRI 是患者的主要负担。尽管在平均随访 3.0 年后实现了根除感染和骨愈合方面的成功治疗，但受影响患者的身心健康受到限制。因此，有必要采用以患者为中心的治疗方法，重点是改善治疗期间和治疗后的生活质量。