Sitanshu Barik, Denish Chandrakar, Piyush Chauhan, Saurabh Sah, Samir C Dwidmuthe
Ilizarov treatment places considerable psychosocial and caregiving demands on families. Strengthening family-centred care, including structured counselling and caregiver education, may improve treatment experiences for children undergoing limb reconstruction.
BACKGROUND: Circular external fixation using the Ilizarov method is widely used in paediatric orthopaedics for deformity correction and limb reconstruction. Although clinical outcomes are well documented, the psychosocial and caregiving experiences of families during prolonged frame treatment remain underexplored, particularly in low- and middle-income settings. This study aimed to explore parents' lived experiences during their child's treatment with a circular external fixator.
METHODS: A qualitative exploratory study was conducted in the paediatric orthopaedic unit of a tertiary care teaching hospital in central India. Parents or primary caregivers of children undergoing or recently completing Ilizarov treatment were recruited using purposive maximum-variation sampling. Data were collected through semi-structured, in-depth interviews and analysed using reflexive thematic analysis following Braun and Clarke's approach. Rigour was enhanced through investigator triangulation, reflexive journaling, and the maintenance of an audit trail.
RESULTS: Twelve parents participated in the study. Six major themes emerged: Confronting the diagnosis, trust in the healthcare team, caregiving burden during the frame period, financial and travel hardship, emotional coping strategies, and recovery with reflection. Parents initially experienced fear and uncertainty but gradually adapted to the demands of frame care. Trust in clinicians and family support were key factors facilitating coping.
CONCLUSION: Ilizarov treatment places considerable psychosocial and caregiving demands on families. Strengthening family-centred care, including structured counselling and caregiver education, may improve treatment experiences for children undergoing limb reconstruction.
CLINICAL SIGNIFICANCE: Understanding caregiver experiences during Ilizarov treatment highlights the substantial psychosocial, logistical, and financial burden on families. Incorporating structured pre-treatment counselling, caregiver training, and family-centred support strategies may improve treatment adherence, reduce complications, and enhance overall patient and caregiver outcomes in paediatric limb reconstruction.