title: The short musculoskeletal functional assessment (SMFA) score  amongst surgical patients with reconstructive lower limb injuries  in war wounded civilians.
abstract: OBJECTIVE
  The MSF programme in Jordan provides specialized reconstructive surgical care to war-wounded civilians in the region. The short musculoskeletal functional assessment score (SMFA) provides a method for quantitatively assessing functional status following orthopaedic trauma. In June 2010 the Amman team established SMFA as the standard for measuring patients’ functional status. The objective of this retrospective study is to evaluate whether the SMFA scores can be useful for patients with chronic war injuries.
  
  
  METHODS
  All patients with lower limb injuries requiring reconstruction were enrolled in the study. Each patient's SMFA was assessed at admission, at discharge from Amman and during follow-up in home country. In the analysis we compared patients with infected versus non-infected injuries as well as with both high and low admissions dysfunctional index (ADI).
  
  
  RESULTS
  Among infected patients, higher ADI correlated with more surgeries and longer hospital stay. Infected patients with ADI >50 required an average of 2.7 surgeries while those with ADI <50, averaged 1.7 operations (p = 0.0809). Non-infected patients with ADI >50 required an average of 1.6 operations compared to 1.5 for those with ADI <50 (p = 0.4168).
  
  
  CONCLUSIONS
  The ADI score in our sample appeared to be useful in two areas: (1) hospital course in patients with infection, where a high ADI score correlated with longer hospital stays and more surgeries, and (2) prognosis, which was better for non-infected patients who had high ADI scores. A scoring system that predicts functional outcome following surgical reconstruction of lower limb injuries would be enormously useful.
authors.forename: Carrie
authors.initials: C
authors.lastname: Teicher
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Foote
authors.forename: Ali M K
authors.initials: AM
authors.lastname: Al Ani
authors.forename: Majd S
authors.initials: MS
authors.lastname: Alras
authors.forename: Sufyan I
authors.initials: SI
authors.lastname: Alqassab
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Baron
authors.forename: Khalid
authors.initials: K
authors.lastname: Ahmed
authors.forename: Patrick
authors.initials: P
authors.lastname: Herard
authors.forename: Rasheed M
authors.initials: RM
authors.lastname: Fakhri
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000503:physiopathology* / Q000601:surgery; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007597:Jordan; D035002:Lower Extremity / Q000098:blood supply / Q000293:injuries*; D008297:Male; D008887:Military Medicine; D009141:Musculoskeletal System / Q000293:injuries* / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D057772:Vascular System Injuries / Q000503:physiopathology* / Q000601:surgery; D014857:Warfare; D014947:Wounds and Injuries / Q000503:physiopathology* / Q000601:surgery; D014948:Wounds, Gunshot / Q000503:physiopathology