Abstract
Introduction
There is a drive to reduce length of stay in children undergoing limb reconstruction but a reduction in community physiotherapy input and a consequent pressure to ensure children are as independent as possible prior to discharge. This study aims to look at time taken and potential factors effecting the achievement of pre-set mobility goals and length of stay in this population
Materials and Methods
Between June 2018 and November 2021 data was collated for patients who underwent limb reconstruction at Great Ormond Street hospital. 77 patients were reviewed. Data collected included type and location of lengthening device and length of stay. A modified version of the Goal Attainment Score (GAS) was used and included 3 goals which the child needed to achieve within 7 days post-operatively.
Results
All children achieved their goals within the 7 days. Length of stay with intramedullary devices was shorter than with external fixators (average of 5 vs 10 days). For children with frames, including the ankle significantly increased hospital stay, whereas inclusion of the knee had no significant effect, and. Bilateral frames were associated with a longer stay.
Conclusions
The use of GAS with pre-defined clinically driven goals could be considered feasible within the limb reconstruction population and possibly used for other patient groups.
This data may enable us to more accurately predict length of stay in patients undergoing limb reconstruction and will provide a baseline for future comparisons of different interventions in this patient group.
