Ho-ho-ho! Gather ’round, my dear friends, for I have a tale to tell—not of elves and reindeer, but of the bustling workshops of modern medicine, where the craft of healing is as vital as the toys we make for Christmas. In this narrative, we shall explore the land of fractures, where the number of patients is rising like the number of children on my Nice List, and the impact on our healthcare systems and society is as heavy as my sleigh on Christmas Eve.

In our story, the wise healers sought to improve the care of their patients, much like I check my list twice to ensure every child gets the right toy. They used magical tools called PROM(I)S, which, unlike my list, measure not who’s naughty or nice, but the health domains that matter most to those with broken bones.

In an observational cohort study, as meticulous as the elves’ toy-making records, patients aged 18 and older, with fractures treated both conservatively and surgically, were included. From November 2020 to June 2022, these patients, like the children awaiting Christmas morning, were followed for up to one year. They completed PROMs, which are akin to the letters I receive, telling me about their physical function, pain interference, and their ability to join in the festive dance of social roles and activities.

A grand total of 746 patients, with an average age of 54.4 years—mind you, a bit older than those who write to me—were included. The PROMIS scores, like the levels of Christmas cheer, were found to be lower in those with lower extremity (LE) fractures compared to the upper extremity (UE) fracture group. It seems that those with UE fractures were more like reindeer in flight, showing physical progression earlier and experiencing fewer limitations.

However, when it came to pain interference, those with UE fractures took a bit longer to feel better, much like the patience needed when waiting for the first snow. As for participating in social roles, significant improvement was only seen in the UE fracture group after one year, much like the joy that comes from finally finding the perfect Christmas tree.

In conclusion, my dear friends, both upper and lower extremity fractures can put a damper on one’s physical function and social health, much like a blizzard can slow down my Christmas Eve journey. But fear not, for these PROMIS questionnaires, like my trusty list, can guide the timing of measurements and help ensure that every patient, much like every child, receives the care they need, when they need it. And with that, I wish you all a healthy and merry season, with the hope that your bones stay as strong as the Christmas spirit! 🎅🎄