Effect of Effleurage Abdominal Massage on Postoperative Constipation for Patients With Lower Limb Fractures: Randomized Controlled Trials

Background Postoperative constipation is a common complication in patients with lower limb fractures, often exacerbated by factors such as opioid use, reduced mobility, and underlying health conditions, leading to the exploration of effleurage abdominal massage as a potential intervention to improve bowel function and alleviate discomfort. Aim To assess the effect of effleurage abdominal massage on postoperative constipation for patients with lower limb fractures. Methods A randomized controlled trail design was used with 100 adult patients undergoing lower limb fracture surgery at Assiut University Hospital, divided into a massage group ( n = 50) and a control group ( n = 50). The primary outcome was postoperative constipation severity, measured using the Constipation Scoring System (CSS) and Bristol Stool Scale. Analyses were conducted on a per‐protocol basis. Descriptive statistics included mean (SD) for continuous variables and n / N (%) for categorical variables. Between‐group comparisons were performed using independent t ‐tests or Mann–Whitney U tests and chi‐square tests for categorical data. Results Baseline demographic and clinical characteristics were similar between groups. The massage group achieved a higher proportion of ideal stool types (Bristol Type 4: 32/50, 64%) compared with the control group (18/50, 36%; p = 0.01). Mean constipation scores were lower in the massage group (CSS 9.5 ± 3.2) than in controls (CSS 13.4 ± 4.1; p = 0.001). Stool frequency/day was higher in the massage group (1.8 ± 0.6) versus control (1.2 ± 0.5; p = 0.004). Older age, male gender, higher BMI, and smoking were positively correlated with increased constipation severity. Conclusion Effleurage abdominal massage significantly improved postoperative constipation by softening stool consistency and reducing harder stools, with age, gender, BMI, and smoking history influencing constipation severity. Recommendation Integrating effleurage abdominal massage into postoperative care protocols, particularly for patients at risk of constipation, and considering personalized approaches addressing demographic and lifestyle factors.