The aim of this study was to quantify and characterise the return of functional mobility following open tibial fracture (OTF) using the Hamlyn Mobility Score (HMS). Twenty patients who had undergone post-traumatic lower limb reconstruction were followed up at 3-month intervals for 1-year. An ear-worn motion sensor (e-AR, Imperial College London) was used to assess the performance of subjects during a short activity protocol. The HMS and its constituent kinematic features were calculated longitudinally, allowing mobility analysis throughout recovery as well as between subjects with varying severity of injury. Functional mobility of the cohort improved throughout the full follow-up period. Patients with more severe fractures appeared to recover at a slower rate, with Gustilo-1 (G1) completing the majority of their recovery within the first 3-months, G2 until 6-months, G3 patients until 9-months. Gait analysis revealed walking quality continues to improve 12-months postoperatively, whereas walking capacity plateaus after 6-months. Late complications were detected where subject recovery trajectories deviated >0.5 SD below that of the cohort. This is the first objective, longitudinal assessment of functional recovery in the OTF cohort, providing multidimensional evidence which begins to clarify the differences in prognosis associated with fracture severity.
4Revised manuscript Jan '15