Introduction: Nearly 20% of Americans consider themselves disabled. A common cause of disability is unexpected orthopaedic trauma. The purpose of this current study, assessing common lower extremity trauma, is the following: to assess the prevalence of self-reported feelings of disability following these injuries, to determine if self-reported feelings of disability impact functional outcomes, and to understand patient characteristics associated with self-reported feelings of disability.
Methods: The functional status of patients with tibial plateau fractures and ankle fractures were prospectively assessed. Patient reported feelings of disability (acquired from validated functional outcome surveys), which were compared with overall patient reported functional outcome and emotional status at each follow-up visit. Additionally, patient demographics were analyzed, to assess associations with feelings of disability.
Results: A total of 710 patients were included in our analysis. At short-term follow-up (3-months), a strong positive correlation existed between self-reported feelings of disability and worse functional outcomes (rs = .744, P<0.001). At long-term follow-up (12-months), a strong positive correlation existed between self-reported feelings of disability and worse functional outcomes (rs = .741, P<0.001). Self-reported feelings of disability were associated with increased age at both short-term (P = 0.015) and long-term (P = 0.003) follow-up. Self-reported feelings of disability declined at each follow-up visit, from 48.1% at short-term follow-up to 22.1% at long-term follow-up. 
Conclusion: Self-reported feelings of disability, following lower extremity trauma, had strong positive correlations with worse outcomes, at both short-term and long-term follow-up. Orthopaedic trauma surgeons should be aware of the percentage of patients who feel disabled following lower extremity fractures, and know that this is associated with sub-optimal outcomes.

Self-Reported Feelings of Disability Following Lower-Extremity Orthopaedic Trauma