title: A qualitative approach to recovery after open tibial fracture: the road to a novel, patient-derived recovery scale.
abstract: OBJECTIVE
  The aim of this study was to describe how patients perceive their recovery following open tibial fractures using a qualitative approach.
  
  
  METHODS
  Following the appropriate ethical approval, adult patients with a diagnosis of open tibial fracture were recruited after completion of their surgical treatment and discharge from Morriston Hospital, a centre with orthoplastic surgical care. A purposive sampling method was employed to ensure that a range of injuries as well as clinical outcomes were included. All patients took part in an in-depth semi-structured interview, exploring aspects of their injury, treatment, rehabilitation and psychosocial and financial situations. Interviews were completed with two interviewers present and were recorded for verbatim transcription. Interview transcripts were analysed to identify items important to patients during their recovery.
  
  
  RESULTS
  Nine patients with a mean injury to interview interval of 2.3 years were interviewed. A total of 538 items were identified and subsequently mapped onto 18 categories: pain; mobility; flexibility; temperature (effects on symptoms); fear; appearance; sleep; diet/weight; employment; social; finance; impact on others; self-care; recovery (patient perceptions of recovery); frustration; goal setting (by patients and health-care providers); and adaptation (both physical and mental).
  
  
  CONCLUSIONS
  There is a wide range of factors that our cohort found important during their recovery from open tibial fracture. Despite being considered as 'healed' by the medical staff, patients did not report a corresponding full recovery and return to pre-injury normality. The categories identified will enable the development of a patient-reported recovery scale to be used in lower-limb trauma.
authors.affiliation: Department of Trauma and Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK. ryan@trickett00.fsnet.co.uk
authors.forename: R W
authors.initials: RW
authors.lastname: Trickett
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mudge
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
authors.forename: Ian
authors.initials: I
authors.lastname: Pallister
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D017102:Fracture Healing; D005597:Fractures, Open / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010465:Perception; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013978:Tibial Fractures / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome