Impact of Limb Deformity Correction Surgery on Pediatric Quality of Life as Assessed by the Limb Deformity Early Onset Scoliosis Questionnaire and Limb Deformity Scoliosis Research Society Patient-Reported Outcome Measures.

BACKGROUND

The influence of pediatric limb deformity (LD) treatment on a child's quality of life is not well described. A previous study established preliminary validity and reliability of the LD Early Onset Scoliosis Questionnaire (LD-EOSQ) and LD Scoliosis Research Society (LD-SRS) in pediatric LD patients but did not assess patients postoperatively. This multicenter, prospective study assesses changes in these patient-reported outcome measures (PROMs) between preoperative and postoperative scores.

METHODS

We enrolled 27 children 18 years and under who had limb deformity surgery (15 guided growth, 9 acute osteotomy, 5 internal lengthening nail, and 3 external fixation procedures). Children and/or their guardians completed the LD-EOSQ (ages 10 and younger, n = 11) or LD-SRS (ages 11-18, n = 16) at their initial visit and the most recent postsurgical follow-up visits (range 1-5 years).

RESULTS

Significant improvements were observed among the parental (effect size = 0.6, P = .04) and financial impact (ES = 0.8, P = .01) content subgroups as measured by the LD-EOSQ. Significant improvements were observed among the function/activity (ES = 0.5, P = .03) and self-image/appearance (ES = 0.5, P = .04) content subgroups as measured by the LD-SRS. Global improvements (ES = 0.6, P = .01) were found in the LD-SRS cohort.

CONCLUSIONS

Improved LD-EOSQ and LD-SRS scores suggest that the family and patients' quality of life were enhanced by limb deformity correction, which helps validate the use of these instruments in assessing pediatric limb deformity surgery. LD-EOSQ and LD-SRS are promising instruments that may be used in future studies to clarify the efficacy of different surgical treatments for pediatric limb deformity patients.

KEY CONCEPTS: (1)Two patient-reported outcome measures, the limb deformity Early Onset Scoliosis Questionnaire and limb deformity Scoliosis Research Society, are preliminarily validated for use in pediatric limb deformity patients.(2)Comparison of pre- and postoperative limb deformity Early Onset Scoliosis Questionnaire surveys revealed that young children (≤10 years) primarily experienced improvements in family life domains.(3)The limb deformity Scoliosis Research Society comparisons revealed that older children (11-18 years) experienced improvements in function, self-image, and overall quality of life.

LEVEL OF EVIDENCE: II, Prospective Cohort Study.