McMaster University

McMaster University

Development and preliminary validation of a Function IndeX for Trauma

We are pleased to share with you the most recent publication from the MacOrtho team titled “Development and preliminary validation of a Function IndeX for Trauma (FIX-IT)”

Find the abstract below and click here to access the full-version of the article.

Bhandari M, Wasserman SM, Yurgin N, Petrisor B, Sprague S, Dent RE. Development and preliminary validation of a Function IndeX for Trauma (FIX-IT). Can J Surg. 2013 Oct;56(5):E114-20.


Background: Assessing fracture healing in clinical trials is subjective. The new Function IndeX for Trauma (FIX-IT) score provides a simple, standardized approach to assess weight-bearing and pain in patients with lower extremity fractures. We conducted an initial validation of the FIX-IT score.

Methods: We conducted a cross-sectional study involving 50 patients with lower extremity fractures across different stages of healing to evaluate the reliability and preliminary validity of the FIX-IT score. Patients were independently examined by 2 orthopedic surgeons, 1 orthopedic fellow, 2 orthopedic residents and 2 research coordinators. Patients also completed the Short Form-36 version 2 (SF-36v2) questionnaire,
and convergent validity was tested with the SF-36v2.

Results: For interrater reliability, the intraclass correlation coefficents ranged from 0.637 to 0.915. The overall interrater reliability for the total FIX-IT score was 0.879 (95% confidence interval 0.828–0.921). The correlations between the FIX-IT score and the SF-36 ranged from 0.682 to 0.770 for the physical component summary score, from 0.681 to 0.758 for the physical function subscale, and from 0.677 to 0.786 for the role–physical subscale.

Conclusion: The FIX-IT score had high interrater agreement across multiple examiners. Moreover, FIX-IT scores correlate with the physical scores of the SF-36. Although additional research is needed to fully validate FIX-IT, our results suggest the potential for FIX-IT to be a reliable adjunctive clinician measure to evaluate healing in lower extremity fractures.

Level of evidence: Diagnostic Study Level I.

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