Development and preliminary validation of a Function IndeX for Trauma (FIX-IT).
BACKGROUND
Assessing fracture healing in clinical trials is subjective. The new Function IndeX for Trauma (FIX-IT) score provides a simple, standardized approach to assess weight-bearing and pain in patients with lower extremity fractures. We conducted an initial validation of the FIX-IT score.


METHODS
We conducted a cross-sectional study involving 50 patients with lower extremity fractures across different stages of healing to evaluate the reliability and preliminary validity of the FIX-IT score. Patients were independently examined by 2 orthopedic surgeons, 1 orthopedic fellow, 2 orthopedic residents and 2 research coordinators. Patients also completed the Short Form-36 version 2 (SF-36v2) questionnaire, and convergent validity was tested with the SF-36v2.


RESULTS
For interrater reliability, the intraclass correlation coefficients ranged from 0.637 to 0.915. The overall interrater reliability for the total FIX-IT score was 0.879 (95% confidence interval 0.828-0.921). The correlations between the FIX-IT score and the SF-36 ranged from 0.682 to 0.770 for the physical component summary score, from 0.681 to 0.758 for the physical function subscale, and from 0.677 to 0.786 for the role-physical subscale.


CONCLUSIONS
The FIX-IT score had high interrater agreement across multiple examiners. Moreover, FIX-IT scores correlate with the physical scores of the SF-36. Although additional research is needed to fully validate FIX-IT, our results suggest the potential for FIX-IT to be a reliable adjunctive clinician measure to evaluate healing in lower extremity fractures.


METHODS
Diagnostic Study Level I.
The Division of Orthopaedic Surgery, Department of Surgery, and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Mohit
M
Bhandari
Scott M
SM
Wasserman
Nicole
N
Yurgin
Brad
B
Petrisor
Sheila
S
Sprague
Ricardo E
RE
Dent
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D017102:Fracture Healing; D006305:Health Status Indicators; D006801:Humans; D007869:Leg Injuries; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D016474:Weight-Bearing