Functional impairment and associated factors among adults with upper extremity fractures at comprehensive specialized hospitals in Gojjam Zones, Northwest Ethiopia: Ordinal logistic regression analysis

Introduction Upper extremity fractures are common injuries that can lead to significant functional impairment, adversely affecting daily activities and quality of life. However, evidence on functional impairment and its factors is limited. Objective To assess functional impairment and associated factors among adults with upper extremity fractures in Gojjam Zones, Northwest Ethiopia. Methods A facility-based cross-sectional study was conducted involving 423 adults attending orthopedic follow-up for upper extremity fractures. Participants were selected through simple random sampling. Data collection involved structured interviewer-administered questionnaires and chart reviews using Kobo Collect. Functional impairment was measured using the Disabilities of Arm, Shoulder, and Hand (DASH) and the Upper Extremity Functional Index (UEFI-20) questionnaire. Data were analyzed with SPSS, and ordinal logistic regression identified factors associated with functional impairments. Results Of 423 eligible participants, 402 participated in the study, yielding a 95% response rate. Functional impairment was categorized as severe (39.1%), moderate (23.9%), mild (18.2%), and minimal/no impairment (18.9%). Males had lower odds of severe functional impairment compared to females (AOR = 0.48; 95% CI = 0.2-0.8). Participants with non-traumatic fractures had lower odds of severe impairment risk compared to those with traumatic fractures (AOR = 0.34; 95% CI = 0.1-0.9). use of traditional or alternative fracture management methods was associated with twice higher odds of severe impairment compared to surgical fixation methods (AOR = 2; 95% CI = 1.5-8.6). Receiving physiotherapy was associated with 69% lower odds of severe impairment compared to their counterparts (AOR = 0.31; 95% CI = 0.2–0.5). Additionally, severe pain (AOR = 2; 95% CI = 1.5-3.3), fracture-related complications (AOR = 2; 95% CI = 1.2-3.1), and open fractures (AOR = 1.6; 95% CI = 1.1-2.5) were associated with increased odds of severe impairment. Conclusion Functional impairment after upper extremity fractures was significant and related to female sex, absence of physiotherapy, presence of complications, severe pain, open fractures, and traditional treatment.