Impact of Limb Deformity Correction Surgery on Pediatric Quality of Life as Assessed by the Limb Deformity Early Onset Scoliosis Questionnaire and Limb Deformity Scoliosis Research Society Patient-Reported Outcome Measures

The influence of pediatric limb deformity (LD) treatment on a child’s quality of life is not well described. A previous study established preliminary validity and reliability of the LD Early Onset Scoliosis Questionnaire (LD-EOSQ) and LD Scoliosis Research Society (LD-SRS) in pediatric LD patients but did not assess patients postoperatively. This multi-center, prospective study assesses changes in these patient-reported outcome measures (PROMs) between preoperative and postoperative scores. We enrolled 27 children 18 years and under who had limb deformity surgery (15 guided growth, 9 acute osteotomy, 5 internal lengthening nail, and 3 external fixation procedures). Children and/or their guardians completed LD-EOSQ (ages 10 and younger, n = 11) or LD-SRS (ages 11 to 18, n = 16) at their initial visit and most recent post-surgical follow-up visits (range 1-5 years). Significant improvements were observed among the parental (effect size = 0.6, p = 0.04) and financial impact (ES = 0.8, p = 0.01) content subgroups as measured by the LD-EOSQ. Significant improvements were observed among the function/activity (ES = 0.5, p = 0.03) and self-image/appearance (ES = 0.5, p = 0.04) content subgroups as measured by the LD-SRS. Global improvements (ES = 0.6, p = 0.01) were found in the LD-SRS cohort. Improved LD-EOSQ and LD-SRS scores suggest that family and patients’ quality of life was enhanced by limb deformity correction, which helps validate the use of these instruments in assessing pediatric limb deformity surgery. LD-EOSQ and LD-SRS are promising instruments that may be used in future studies to clarify the efficacy of different surgical treatments in pediatric limb deformity patients. Level II, prospective cohort study. Two patient-reported outcome measures, the LD-EOSQ and LD-SRS, are preliminarily validated for use in pediatric limb deformity patients. Comparison of pre- and postoperative LD-EOSQ surveys revealed that young children (≤ 10 years) primarily experienced improvements in family life domains The LD-SRS comparisons revealed that older children (11-18 years) experienced improvements in function, self-image, and overall quality of life. • The LD-EOSQ and LD-SRS were created to address the need for pediatric LD PROMs • Younger children (≤ 10 years) experienced post-operative family life improvements • Older children (11-18 years) had better function and self-image post-operatively