title: Life impact of ankle fractures: qualitative analysis of patient and clinician experiences.
abstract: BACKGROUND
  Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them.
  
  
  METHODS
  A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers.
  
  
  RESULTS
  Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes.
  
  
  CONCLUSIONS
  The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.
authors.affiliation: Centre for Functioning and Health Research, Metro South Health, Buranda Plaza, Corner Ipswich Road and Cornwall Street Buranda, Brisbane, Australia. steven_mcphail@health.qld.gov.au
authors.forename: Steven M
authors.initials: SM
authors.lastname: McPhail
authors.forename: Joel
authors.initials: J
authors.lastname: Dunstan
authors.forename: Julie
authors.initials: J
authors.lastname: Canning
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000523:psychology* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult