Combined pubic rami and sacral osteoporotic fractures: A prospective study of 67 patients

Abstract

Abstracts / Injury Extra 42 (2011) 95-169 clinical outcome were recorded and analysed. Health-related quality-of-life was assessed using the EuroQol-5D and sexual function using the international index of erectile function and the female sexual function index. Patients were asked to fill the questionnaires twice (once documenting their state prior to their injury and the second time recording their state after the injury). The minimum follow up was 12 months (range 12-30).Results: Out of 85 patients that met the inclusion criteria, 67 patients (24 females) with a mean age of 44 years (19-65) consented to participate in this study. Their mean ISS was 25 (9-58), while 5 (7.4%) had isolated fractures. There was shown to be a significant decrease in quality-of-life (p < 0.0001) and sexual function (p < 0.0001). The decrease was significant in all 5 EQ5D domains with mobility, usual activities, and pain as the most significantly affected (p < 0.0001). 50.7% (34) patients reported a significant (p < 0.0001) decrease in their post-injury sexual function score (55.5% males, 47.8% females). Linear regression showed urinary tract injury to be an independent risk factor for sexual dysfunction (p < 0.0001), while a Mann-Whitney U-test identified that the PFX severity (VS-AP3-LC3-CMI vs. LC1-LC2-AP1-AP2-ILBL) correlated to sexual dysfunction (p = 0.0463).Conclusion: Both genders, irrespective of age subgroups, suffering a PFX severe enough to undergo surgery, are at risk of a significant decrease of their quality of life and sexual function. The presence of certain fracture types and urinary tract injuries can be used as predictors of late morbidity and early multidisciplinary management.Intent: To assess the accuracy of circumferential pelvic binder positioning and its effect on diastasis reduction of unstable pelvic ring fractures.Methods: Accuracy of binder position. Patients were identified by a retrospective review of all pelvic radiographs performed at a military hospital between January 2008 and July 2010. Patients were included if there were visible metallic coils of the binder buckle. Patients were grouped according to the vertical level of the buckle, relative to an index line between the widest points of both trochanters (level A > 60 mm superior, level B -60 mm superior to 50 mm inferior and level C > 50 mm inferior, relative to the index line respectively). Binder position and diastasis reduction. All radiographs and CT images from the first part of the study were assessed to identify the presence of any pelvic fracture. Diastasis reduction was measured in patients with Anterior-Posterior Compression grades II and III, or Combined Mechanical Injuries.Results: We identified 172 radiographs with a visible pelvic binder. The binder was positioned over the greater trochanters in 49% of radiographs. In the patients with fractures, the mean pelvic diastasis gap was 22 mm less when the pelvic binder was positioned over the greater trochanters compared to level A (p < 0.01).Conclusions: This report is the first to hig...