Functional outcome of patients with unstable pelvic ring fracture

Abstract

The purpose of this study was to evaluate factors that correlated with unsatisfactory short- and long-term outcome in patients who sustained unstable pelvic ring fracture. The study subjects of this study were those of type B and C pelvic ring fractures (82 patients; mean age 54 years). Age, gender, associated injuries, fracture type, Injury Severity Score rating and treatment methods were assessed, and Majeed score for functional outcome and radiographic studies at 1 year after injury (short-term) and at final follow-up (long-term), with mean follow-up of 98 months were analyzed. Significant univariate factors ( p < 0.05) were entered in a multivariate logistic regression model to determine the independent predictors of unsatisfactory functional outcome. Univariate analysis showed that fractures of the lower extremity, nerve damage, conservative treatment, and radiological outcome correlated with unsatisfactory short-term functional outcome, while female gender, brain injury, nerve damage, conservative treatment, fracture location at the posterior portion of pelvic ring, radiological outcome, and pure sacroiliac dislocation only for type C fracture correlated with unsatisfactory long-term outcome. Multiple logistic regression analysis identified fractures of the lower extremity (odds ratio (OR): 5.364), conservative treatment (OR: 13.690), and nerve damage (OR: 21.392) as determinants of unsatisfactory short-term functional outcome and nerve damage (OR: 66.926) and poor radiological results (OR: 33.944) as determinant of long-term functional outcome. In patients with unstable pelvic ring injury, fractures of the lower extremity, conservative therapy, and nerve damage influenced short-term functional outcome, while that nerve damage and the pelvic ring displacement over 20 mm negatively affected long-term outcome.

Patient-reported physical functioning and quality of life after pelvic ring injury: A systematic review of the literature

“…Seven studies [ 19 , 38 , 39 , 46 , 50 , 51 , 53 ] only described the mean, ranging from 75 up to 95. Three studies [ 20 , 21 , 35 ] combined ‘excellent’ and ‘good’ results to ‘satisfactory’ (range 56–85%) and ‘poor’ and ‘fair’ to ‘unsatisfactory’ (range 15–37%). The Iowa Pelvic Score (IPS) was used by one study [ 8 ].…”

“…Three studies described physical functioning at different time points, and almost all of them showed improved scores at a later stage. Kokubo et al [ 35 ] applied the MPS at one year and once again after a mean of 7.4 years, while Li et al [ 36 ] also applied the MPS at one year and 10 years after the injury. Kokubo et al found satisfactory (excellent + good) results of 63% after 1 year and 85% after 7.4 years.…”

Avaliação da concordância interobservador no diagnóstico de lesões do anel pélvico posterior usando radiografia simples

“…Posterior pelvic ring injuries are severe and difficult to diagnose, 7 8 9 10 often requiring urgent stabilization to reestablish the polytraumatized patient from the hemodynamic point of view, 11 12 13 14 and/or subsequent surgical procedures to fix fractures or dislocations, enabling the patient to return to his or her best functional condition.…”

“…As lesões do anel pélvico posterior são graves e de difícil diagnóstico, 7 8 9 10 exigindo, muitas vezes, estabilização de urgência que restabeleça, do ponto de vista hemodinâmico, o paciente politraumatizado 11 12 13 14 e/ou procedimentos cirúrgicos subsequentes com vistas à fixação de fraturas ou luxações, permitindo o retorno do paciente à sua melhor condição funcional.…”

Placas anteriores são mais efetivas do que parafusos iliossacrais na fixação da articulação sacroilíaca? Estudo Biomecânico

“…As lesões pélvicas podem danificar as estruturas intrapélvicas e o feixe neurovascular, produzindo hemorragias graves com altas taxas de mortalidade. 1 2 3 4 …”