title: Long-term functional outcome and quality of life after successful surgical treatment of tibial nonunions.
abstract: OBJECTIVE
  Our aim was to evaluate quality of life (QoL) and functional outcome of patients with tibial nonunions after completion of surgical treatment with an average follow-up of five years.
  
  
  METHODS
  The following data of 64 patients were retrospectively evaluated: fracture type, type and duration of surgical therapy, range of motion of the knee and ankle and American Orthopaedic Foot and Ankle Society (AOFAS) score. QoL was evaluated with the Short-Form Health Survey (SF-36) questionnaire; pain intensity, patient satisfaction and impairments of daily, professional and sport activities with a ten point visual analogue scale.
  
  
  RESULTS
  QoL, even in cases with successfully completed treatment, was significantly reduced compared with the normal general population. Pain intensity and limited ankle dorsal extension, despite the absence of intra-articular fractures, were significantly correlated with inferior QoL.
  
  
  CONCLUSIONS
  This study emphasises the long-term negative impact of tibial nonunions on patient QoL, even after successful surgical treatment.
authors.affiliation: Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Wichlas
authors.forename: Serafim
authors.initials: S
authors.lastname: Tsitsilonis
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Disch
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Haas
authors.forename: Christian
authors.initials: C
authors.lastname: Hartmann
authors.forename: Frank
authors.initials: F
authors.lastname: Graef
authors.forename: Philipp
authors.initials: P
authors.lastname: Schwabe
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology; D005260:Female; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult