{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:17:02Z","timestamp":1791404222140,"version":"4.3.3"},"reference-count":25,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,9,16]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Treatment of open fractures is complex and patients may require muscle and skin grafts. The aim of this study was to gain a greater understanding of patient experience of recovery from open fracture of the lower limb 2\u20134\u2009years postinjury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A phenomenological approach was used to guide the design of the study. Interviews took place between October 2016 and April 2017 in the participants\u2019 own homes or via telephone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>England, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A purposive sample of 25 patients were interviewed with an age range of 26\u201380 years (median 51), 19 were male and six female, and time since injury was 24\u201349 months (median 35 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings identified a focus on struggling to recover as participants created a new way of living, balancing moving forward with accepting how they are, while being uncertain of the future and experiencing cycles of progress and setbacks. This was expressed through three themes: (i) \u2018being disempowered\u2019 with the emotional impact of dependency and uncertainty, (ii) \u2018being changed\u2019 and living with being fragile and being unable to move freely and (iii) \u2018being myself\u2019 with a loss of self, feeling and looking different, alongside recreation of self in which they integrated the past, present and future to find meaningful ways of being themselves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study identified the long-term disruption caused by serious injury, the hidden work of integration that is required in order to move forward and maximise potential for recovery. Supportive strategies that help people to self-manage their everyday emotional and physical experience of recovery from injury are required. Research should focus on developing and testing effective interventions that provide support and self-management within a holistic rehabilitation plan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Current Controlled Trials\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"ISRCTN33756652\">ISRCTN33756652<\/jats:ext-link>\n                      ; Post-results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-031261","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T03:44:13Z","timestamp":1570679053000},"page":"e031261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["Patient experience of long-term recovery after open fracture of the lower limb: a qualitative study using interviews in a community setting"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4399-2049","authenticated-orcid":false,"given":"Sophie","family":"Rees","sequence":"first","affiliation":[{"name":"Warwick Clinical Trials Unit, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3973-360X","authenticated-orcid":false,"given":"Elizabeth","family":"Tutton","sequence":"additional","affiliation":[{"name":"NDORMS, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juul","family":"Achten","sequence":"additional","affiliation":[{"name":"NDORMS, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Bruce","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, University of Warwick, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L","family":"Costa","sequence":"additional","affiliation":[{"name":"NDORMS, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,9]]},"reference":[{"key":"2025120518550800000_9.10.e031261.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.12.007"},{"key":"2025120518550800000_9.10.e031261.2","doi-asserted-by":"crossref","first-page":"2280","DOI":"10.1001\/jama.2018.6452","article-title":"Effect of negative pressure wound therapy vs standard wound management on 12-month disability among adults with severe open fracture of the lower limb: the WOLLF randomized clinical trial","volume":"319","author":"Costa","year":"2018","journal-title":"JAMA"},{"key":"2025120518550800000_9.10.e031261.3","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1302\/0301-620X.100B4.BJJ-2017-0891.R1","article-title":"A qualitative study of patient experience of an open fracture of the lower limb during acute care","volume":"100-B","author":"Tutton","year":"2018","journal-title":"Bone Joint J"},{"key":"2025120518550800000_9.10.e031261.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.01.027"},{"key":"2025120518550800000_9.10.e031261.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2474-13-224","article-title":"Life impact of ankle fractures: qualitative analysis of patient and clinician experiences","volume":"13","author":"McPhail","year":"2012","journal-title":"BMC Musculoskelet Disord"},{"key":"2025120518550800000_9.10.e031261.6","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.2106\/00004623-200309000-00006","article-title":"Psychological distress associated with severe lower-limb injury","volume":"85","author":"McCarthy","year":"2003","journal-title":"J Bone Joint Surg Am"},{"key":"2025120518550800000_9.10.e031261.7","unstructured":"Heidegger M . 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