Lower extremity fracture prevention and management in persons with spinal cord injuries and disorders: The patient perspective

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2021.1907675 · Published: January 1, 2022

Spinal Cord Injury Patient Experience Musculoskeletal Medicine

Simple Explanation

This study explores the experiences of veterans with spinal cord injuries or disorders (SCI/D) concerning the prevention and treatment of lower-extremity fractures. The research involved conducting telephone interviews with 32 veterans who had experienced at least one lower-extremity fracture within the past 18 months. The study found that many participants lacked knowledge about bone health and fracture prevention and desired more involvement in decisions regarding their fracture treatment.

Study Duration

August 2018 and January 2019

Participants

32 Veterans with SCI/D who had experienced at least one lower-extremity fracture

Evidence Level

Qualitative data via semi-structured telephone interviews

Key Findings

1
Participants expressed concerns about bone health and fractures, which limited activities and participation for some.
2
Few participants reported medication management for osteoporosis, but many received radiographs/scans to confirm fractures.
3
Many reported not feeling fully included in treatment decision-making and described decreased function, independence, or participation post-fracture.

Research Summary

This study describes perspectives of patients with SCI/D on fracture prevention and management and revealed a range of knowledge about osteoporosis and awareness of when a fracture occurred. Participants voiced the desire to feel more included in collaborative decision-making with their physicians for fracture treatment, which several respondents felt was lacking. The data suggest that individuals with SCI/D may benefit from education about bone health and fracture prevention, and how to safely resume pre-fracture participation following LE fracture.

Practical Implications

Improved Patient Education

Offer better education about bone health, fracture prevention, and safe return to activities.

Collaborative Decision-Making

Involve patients more actively in making decisions about their fracture treatment plans.

Comprehensive Post-Fracture Care

Provide support for resuming function and participation after a fracture, including retraining in safe transfers and mobility strategies.

Study Limitations

1
Perspectives from individuals with SCI/D in the general population and women with SCI/D who have experienced a fracture should be incorporated into future work.
2
Future studies may employ a mixed-methods approach (including quantitative data collection strategies such as surveys or medical record reviews) to obtain objective as well as subjective information.
3
We did not take purposive measures to establish reflexivity

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