Patient Preferences for Surgical Versus Non-Surgical Management of Fractures at Mayo Hospital, Lahore
DOI:
https://doi.org/10.61919/jhrr.v5i9.1955Keywords:
fracture; surgery; non-surgical treatment; patient preference; decision-making; Pakistan.Abstract
Background: Fracture management decisions are influenced not only by radiographic and clinical findings but also by patient perceptions regarding cost, pain, recovery, and operative risk. Local evidence on fracture-treatment preference in Pakistan remains limited despite the clinical importance of shared decision-making in orthopedic practice. Objective: To assess patient preferences for surgical versus non-surgical fracture management and to identify factors associated with these preferences among patients presenting to Mayo Hospital, Lahore. Methods: This cross-sectional observational study included 85 adult patients with radiologically confirmed fractures. Data were collected using a structured interviewer-administered questionnaire capturing demographic characteristics, fracture profile, treatment preference, and factors influencing decision-making. Descriptive statistics were used to summarize responses, and associations with preference for surgery were examined using comparative analysis with odds ratios and p-values. Results: Of 85 participants, 49 (57.6%) preferred non-surgical treatment and 36 (42.4%) preferred surgery. Major factors influencing decisions included physician advice in 63 (74.1%), high cost of surgery in 52 (61.2%), fear of postoperative pain in 47 (55.3%), family influence in 41 (48.2%), and fear of surgical complications in 39 (45.9%). Among those refusing surgery, financial cost was the leading reason in 20 of 49 patients (40.8%), followed by fear of postoperative pain in 15 (30.6%). Preference for surgery was significantly associated with severe fracture (p=0.002), severe pain (p=0.001), and failure of conservative treatment (p=0.004). Conclusion: Non-surgical treatment was preferred more frequently than surgery, largely due to cost and fear-related barriers. However, patients were significantly more likely to prefer surgery when fracture severity, pain intensity, and prior treatment failure increased.
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