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Role of patient information handouts following operative treatment of ankle fractures: a prospective randomized study
Mayich DJ, Tieszer C, Lawendy A, McCormick W, Sanders D
Foot & Ankle International 2013 Jan;34(1):2-7
clinical trial
4/10 [Eligibility criteria: No; Random allocation: No; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Widespread evidence exists for directed patient information interventions (eg, pamphlets) in the setting of several orthopaedic conditions and interventions. Up until now, no study had assessed the role of these interventions in the management of patients following ankle fractures. METHODS: Between 2005 and 2007, 40 patients who suffered an operative ankle fracture were randomized to either a standard treatment group for an ankle fracture or an enhanced information group who received an American Academy of Orthopaedic Surgeons ankle fracture information pamphlet that explained postoperative routine at our institution and a physiotherapy handout depicting a standard protocol. Study participants were followed for 3 months clinically and radiographically. At the 6-week and 3-month intervals, study participants completed the Olerud-Molander Questionnaire and 2 questions regarding their level of satisfaction. The primary outcome measure was the Likert-scale-based survey question determining the level of satisfaction with the treating staff. RESULTS: Participants in the enhanced information group were more satisfied with treatment at 3 months (9.2 versus 6.3; p < 0.001). There were significant improvements in work/activity ability at 6 weeks (p = 0.01), but this advantage disappeared at 3 months (p = 0.24). No differences in postoperative complication rates were noted. CONCLUSIONS: Information enhancement in the form of pamphlets can be helpful in providing patients with accessible information in the postoperative period. While they do not seem to have a sustained impact on postoperative outcomes, handouts may enhance the interaction between staff and patient at postoperative visits, improving patient satisfaction. LEVEL OF EVIDENCE: Level I, appropriately powered randomized prospective cohort study.

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