Objective To analyze the characteristics of early symptom patterns and the influencing factors in patients after lower limb bone transport surgery, aiming to provide a reference for clinical symptom management. Methods A total of 260 patients after bone transport surgery were selected via convenience sampling method, then they were investigated by using a general information questionnaire and the Patient-Reported Outcomes Measurement Information System Profile-29 (PROMIS-29). Latent profile analysis was employed to establish symptom subgroup models, and multivariate logistic regression analysis was used to identify the influencing factors. Results The participants′ average scores of the seven dimensions in PROMIS-29 (physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, and pain interference) ranged from 31.75 to 60.22, their average pain intensity score was 3.62. The early symptom could be classified into four latent categories:the good psychological adaptation but impaired physical function group (15.00%), the borderline symptom group (42.69%), the high symptom group (26.54%), and the low symptom group (15.77%). Gender, age, marital status, duration of external fixator use, bone defect length, and pain intensity were the influencing factors of early symptom for different latent categories (all P<0.05). Conclusion There is heterogeneity in the early symptom of patients after lower limb bone transport surgery. Nursing staff should implement targeted nursing interventions based on patients′ different category characteristics and influencing factors to promote functional recovery.