Limb reconstruction: distress, appearance concerns, social support and patient experience

Limb reconstruction is an orthopaedic surgical technique designed to treat
severe fractures, including fractures that have failed to heal using
conventional methods, and congenital deformities. The existing research
suggests high levels of distress among patients, and that the appearance of
the external fixation device is a possible factor contributing to distress, but the
psychological contribution to this research is scarce. The overall aim of this
mixed methods study was to gain a better understanding of the experience of
limb reconstruction patients. In particular, the quantitative study aimed to
investigate levels of psychological distress in adults undergoing limb
reconstruction, and to examine variables that correlate with distress. A crosssectional
sample of patients completed measures of psychological distress,
appearance concern, social support, and pain. The purpose of the qualitative
part of the study was to gain an in-depth understanding of the experience of
adults undergoing limb reconstruction via external fixation device (EFD). Semi
structured interviews were conducted with current patients, and were
analysed using Interpretative Phenomenological Analysis. Self-reported levels
of psychological distress were high. Appearance concern was higher among
younger, female patients. Patients described feelings of vulnerability, and a
fear of falling following their accidents. Patients' identity was called into
question and there were psychological consequences when treatment was
longer than expected. The results are considered in relation to relevant
literature and the implications for intervention are discussed.

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