Functional Outcome in Polytrauma Patients Undergoing Orthopedic Surgery Using Lower Extremity Functional Scale in a Tertiary Center in Bangladesh

Abstract

Background: Polytrauma patients often present with complex injuries requiring multi-disciplinary care, with orthopedic trauma being a major component. Functional outcomes following surgical management remain a critical indicator of long-term recovery. This study aims to assess functional outcome scores in polytrauma patients undergoing orthopedic surgery at Chattogram General Hospital in Bangladesh. Objective: To evaluate the functional recovery and associated clinical parameters in polytrauma patients who underwent orthopedic surgical interventions. Methods: This prospective, observational study was conducted at Chattogram General Hospital from March 2024 to March 2025. A total of 110 polytrauma patients aged ≥18 years who underwent orthopedic surgery were enrolled. Data on demographics, injury mechanism, clinical profile, surgical details, and postoperative complications were collected. Functional outcomes were assessed using the Lower Extremity Functional Scale (LEFS) at 6 weeks, 3 months, 6 months, and 12 months postoperatively. Statistical analysis was performed to identify associations between clinical predictors and functional outcomes. Results: Road traffic incidences were the most common injury mechanism (50%), and extremity injuries were predominant (72.7%). Internal fixation was the most frequently used surgical method (60%). ICU admission was required in 36.4% of patients, and the mean hospital stay was 13.1 ± 4.5 days. LEFS scores showed a significant improvement over time (mean 46.8 at 6 weeks to 83.7 at 12 months). Early surgery (<72h), lower Injury Severity Scores (<16), and absence of ICU admission were significantly associated with better functional outcomes (p<0.05). Conclusion: Orthopedic surgical intervention in polytrauma patients leads to favorable functional recovery, especially when performed early and in patients with lower injury severity. Functional outcome scores serve as valuable tools for monitoring recovery and planning rehabilitation. Continued focus on early intervention and structured follow-up is essential for optimizing long-term outcomes.