Psychological Resilience in Children With Lower Limb Deformities: A Multicenter Quality of Life Study

BACKGROUND: Children with lower-limb deformities encounter complex challenges impacting physical function and well-being. The Limb Lengthening and Reconstruction Society AIM (LLRS-AIM) index provides a standardized assessment of deformity complexity, but the relationship between complexity and quality of life remains poorly understood. This study aims to determine the strength of the relationship between lower limb deformity complexity and health-related quality of life in children and adolescents. METHODS: We conducted a prospective cross-sectional study across 3 international centers over 2 years. Children aged 5 to 18 years with lower limb deformities completed the Pediatric Outcomes Data Collection Instrument (PODCI), while clinicians assessed deformity complexity using the The Limb Lengthening and Reconstruction Society AIM index. Correlations between deformity complexity and quality of life were analyzed, results were compared with published norms, and differences between parent and adolescent reports were examined. RESULTS: Among 150 participants, deformity complexity showed strong negative correlations with global quality-of-life scores. The strongest relationships were observed in children with sports and physical activity function ( r =-0.59, P