Intentional fallers with complex pelvic and acetabular fractures do not have worse radiological and functional outcomes than accidental fallers

Abstract

Intentional fallers with complex pelvic and acetabular fractures were thought to have a worse prognosis because of their mental disorders. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis surgeries and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods Between 2014 and 2017, fallers with complex pelvic and acetabular fractures who survived from resuscitation and complete surgical treatments were enrolled and investigated.Results Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidently. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. Intentional fallers presented with younger age, higher injury severity score and new injury severity score, longer intensive care unit and hospital stay, early loss to follow-up, and worse functional outcomes at the 6-month follow-up. However, the radiological and functional outcomes at the 12-month follow-up did not significantly differ between the intentional and accidental fallers.Conclusion In conclusion, the intentional fallers with complex pelvic and acetabular fractures may have worse clinical presentations initially, but their radiological and functional outcomes may become comparable to those of accidental fallers after treatments.