We also examined the impact of the injuries on the patient's family and friends. Table 12 shows the percentage of patients who reported having family or friends who were affected by their injury. Out of the patients who had family or friends, 80% reported that their family or friends were emotionally affected by their injury, such as feeling sad, worried, or angry. Out of the patients who had family or friends who were financially dependent on them, 70% reported that their family or friends were financially affected by their injury, such as having less income or more expenses.
Functional outcomes of orthopedic injuries The functional outcomes of orthopedic injuries among the patients are presented in Table 10. The functional outcomes were assessed using the Musculoskeletal Function Assessment (MFA) questionnaire, which measures the impact of musculoskeletal disorders on physical, emotional, and social aspects of life. The MFA questionnaire consists of 100 items, each scored on a 5-point Likert scale from 0 (no difficulty) to 4 (unable to do). The total score ranges from 0 to 400, with higher scores indicating worse function. The MFA questionnaire was administered to the patients at 6 months and 12 months after injury.
The mean MFA score at 6 months was 145.6 (SD = 62.3), indicating moderate functional impairment. The mean MFA score at 12 months was 98.4 (SD = 45.6), indicating mild functional impairment. There was a significant improvement in the MFA score from 6 months to 12 months (t = -15.4, df = 3049, p < 0.001). The MFA score was significantly correlated with the type and severity of injury, the number and type of surgeries, the presence and type of complications, and the level of pain. Patients with more severe injuries, more surgeries, more complications, and more pain had worse functional outcomes.
The MFA score was also significantly correlated with the patient's status, sex, and age. Combatants had worse functional outcomes than civilians (t = -8.7, df = 3048, p < 0.001). Females had worse functional outcomes than males (t = -6.2, df = 3048, p < 0.001). Older patients had worse functional outcomes than younger patients (r = 0.32, p < 0.001).
The MFA score was divided into three categories: good function (0-100), fair function (101-200), and poor function (201-400). The distribution of these categories at 6 months and 12 months is shown in Figure 1. At 6 months, only 18% of patients had good function, while 54% had fair function and 28% had poor function. At 12 months, the percentage of patients with good function increased to 42%, while the percentage of patients with fair function decreased to 44% and the percentage of patients with poor function decreased to 14%. These results indicate that most patients improved their function over time, but some patients still had significant functional limitations at one year after injury.
Functional Outcomes of Orthopedic Injuries in Yemen
Note: The percentages are based on the number of patients who reported their function using the MFA questionnaire out of the total number of patients who completed the questionnaire. The MFA score ranges from 0 to 400, with higher scores indicating worse function. The MFA score categories are defined as follows: good function (0-100), fair function (101-200), and poor function (201-400).
