Thomas Kirby, Isaac Cheon, Mia Holmgren, Prashanthi Divakar, Cybele Arsan, Eric Holmgren
The findings indicate that isolated facial fractures are associated with measurable reductions in quality of life, but delay to surgery may not be the primary factor. Instead, patient perceptions of care, particularly worry as it relates to fracture healing and perceived delay in diagnosis, appear to play a meaningful role in shaping quality of life while awaiting surgery. Patient-centered facial fracture treatment may benefit from emphasis on timely diagnosis and clear communication about the healing process alongside appropriate surgical timing.
PURPOSE: To examine patient experience and quality of life while living with an unrepaired facial fracture, particularly in relation to surgical delay.
MATERIALS AND METHODS: Prospective survey study of 36 patients with isolated facial fractures at a rural tertiary care center. Patients completed a preoperative questionnaire assessing demographics, perceptions of care, and quality of life using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), adapted to assess the period from injury to surgery. Associations were measured retrospectively using Spearman correlations (ρ), rank-biserial correlations (rrb), and Fisher's exact tests.
RESULTS: A near-zero correlation was found between delay to surgery and quality of life (ρ = -0.03, 95% CI [-0.38, 0.33]), with a median delay to surgery of 7.5 days and a median Q-LES-Q-SF score of 52%, substantially lower than the published community value of 79%. Worry about how wait time would affect bone healing was associated with lower quality of life (rrb = -0.58, 95% CI [-0.78, -0.29]) as well as perceived delay in diagnosis (rrb = 0.55, 95% CI [0.27, 0.74]).
CONCLUSIONS: The findings indicate that isolated facial fractures are associated with measurable reductions in quality of life, but delay to surgery may not be the primary factor. Instead, patient perceptions of care, particularly worry as it relates to fracture healing and perceived delay in diagnosis, appear to play a meaningful role in shaping quality of life while awaiting surgery. Patient-centered facial fracture treatment may benefit from emphasis on timely diagnosis and clear communication about the healing process alongside appropriate surgical timing.