RLS diagnosis is based on criteria criteria, established by the International Restless Legs Syndrome Study Group; RLS t is often associated with nocturnal PLM.

Pseudoarthrosis is defined as an abnormal union formed by fibrous tissue in fractured bone, not alowing normal reparing. The main cause associated to pseudoarthrosis is poor fracture immobilization.

Retrospective longitudinal analytical observational (cases-control).Patients with consolidated or unconsolidated lower limb fracture(pseudoarthrosis) treated in a secondary hospital. Data collection (demographic/clinical variables) was carried out from clinical records(2011-2017). Blind to the evolution of the fracture(except for one), patients were contacted by phone, evaluating clinical criteria of RLS, PLM perceived by bed partner and night awakenings.

30 patients with Fracture (Fx): 10 pseudoarthrosis group (PSEUDO) and 20 adequate consolidation group (CONS). 59% males. Age at Fx: 38.1a (SD 20) .Fx type: Metatarsal: 64%, Astragalus / calcaneus: 25%, Fibula: 17%.

No significant differences between the PSEUDO / CONS groups in sex, age, type and mechanism of fx.

RLS diagnosis: PSEUDO group 7/10 (70%) vs CONS group 2/20 (10%) (p = 0.003), OR 21 (95% CI: 2.86-153.75). MPP: PSEUDO: 6/10 (60%) vs CONS: 1/20 (5%) (p = 0.010), OR 19 (95% CI: 1.79-201.68). Nocturnal awakenings: positive association (p = 0.004), OR 13.5 (95% CI: 1.95-93.24).

We assess a strong association in patients with distal lower limb fracture developing pseudarthrosis and presenting RLS, PLM and experiencing nocturnal awakenings. These factors could cause lack of immobilization of the fracture, wich we interpret could be an important factor to develop pseudoarthrosis.

More studies are needed to evaluate the usefulness of exploring the diagnosis of RLS / PLM in the patient with a distal lower limb fracture. If confirmed, treatment to control these symptoms could decrease the risk of developing pseudarthrosis.