WOLLF collaborators (Including: Costa, Matthew L., Achten, Juul and Parsons, Nick). (2022) Five-year outcomes for patients sustaining severe fractures of the lower limb. The Bone & Joint Journal, 104-B (5). pp. 633-639. doi:10.1302/0301-620X.104B5.BJJ-2021-1568.R2 ISSN 2049-4394.

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Abstract

Aims
The aim of this study was to report the outcomes of patients with severe open fractures of the lower limb in the five years after they took part in the Wound management for Open Lower Limb Fracture (WOLLF) trial.

Methods
The WOLLF trial compared standard dressings to negative pressure wound therapy (NPWT) applied at the end of the first surgical wound debridement, and patients were followed-up for 12 months. At 12 months, 170 of the original 460 participants agreed to take part in this medium-term follow-up study. Patients reported their Disability Rating Index (DRI) (0 to 100, where 100 is total disability) and health-related quality of life (HRQoL) using the EuroQol five-dimension three-level health questionnaire (EQ-5D-3L) annually by self-reported questionnaire. Further surgical interventions related to the open fracture were also recorded.

Results
There was no evidence of a difference in patient-reported disability, HRQoL, or the need for further surgery between patients treated with NPWT versus standard dressings at five years. Considering the combined results for all participants, there was a small but statistically significant change in DRI scores over time (1.6 units per year; p = 0.005), but no evidence that EQ-5D-3L scores changed significantly during years two to five (p = 0.551).

Conclusion
This study shows that the high levels of disability and reduced HRQoL reported by patients 12 months after severe open fractures of the lower limb persist in the medium term, with little evidence of improvement between years two and five.

Item Type:	Journal Article
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	The Bone & Joint Journal
Publisher:	British Editorial Society of Bone and Joint Surgery
ISSN:	2049-4394
Official Date:	1 May 2022
Dates:	Date Event 1 May 2022 Published
Volume:	104-B
Number:	5
Page Range:	pp. 633-639
DOI:	10.1302/0301-620X.104B5.BJJ-2021-1568.R2
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Copyright Holders:	© 2022 The British Editorial Society of Bone & Joint Surgery

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