Patient-reported Outcome in Surgically Treated Pelvic Ring Injuries at 5 Years Post-surgery

Abstract

Background and Aims: Long-term prospective data on patient-reported outcome after surgical treatment of pelvic ring injuries are scarce. This study aimed at describing results at 5 years post-surgery using validated outcome measures. Patients and Methods: Patients admitted for surgical treatment of pelvic ring injuries were prospectively included and asked to report their outcome at 1, 2 and 5 years post-surgery using two patient-reported outcome measures: the generic Short-Form 36 and the condition-specific pelvic discomfort index. Data were evaluated using mixed-effects linear models. Results: There were 108 patients (68 males and 40 females), mean age 38 years. Injury type according to the AO/OTA-classification was B-type in 68 patients and C-type in 40 patients. No domain of the Short-Form 36 reached norm values at 5 years post-surgery. Females reported a worse outcome than males concerning general health ( p < 0.01) at 5 years. Recovery of physical function ( p < 0.01), mental health ( p = 0.04), and pain ( p = 0.01) was observed for males at 5 years compared to earlier assessments, while females on the contrary described more pain at this time-point ( p = 0.03). Mean pelvic discomfort index at 5 years was 27, indicating moderate residual pelvic discomfort overall. Males reported less pelvic discomfort than females at 5 years ( p = 0.02) and improved when compared to results at 2 years ( p = 0.02), while females did not. Influence of age, fracture type, and presence of associated injuries on patient-reported outcome was limited. Conclusion: Surgically treated pelvic ring injuries are associated with long-standing negative effects on patient-reported outcome. Males report a better outcome than females at 5 years post-surgery.

Quality of Life from Return to Work and Sport Activities to Sexual Dysfunction after Surgical Treatment of Pelvic Ring Fractures

“…Gender stratification of patients self-reported QoL has been scarcely investigated in the literature so far, with controversial findings. Hernefalk et al in 2019 [ 36 ] prospectively studied the long-term functional outcome of surgically treated pelvic ring B- or C-type disruptions. In contrast to the current study, they reported worse functional outcomes in females at a 5-year follow-up, both in the generic (SF-36) as well as in other condition-specific outcome measures.…”

“…In contrast to the current study, they reported worse functional outcomes in females at a 5-year follow-up, both in the generic (SF-36) as well as in other condition-specific outcome measures. However, the difference between male and female mechanisms of injury was not evaluated in that series [ 36 ]. The lack of baseline gender analysis on the mechanism of injury hinders the possibility of interpreting if those findings were driven by a higher number of high-energy traumas or by specific sex-related characteristics of the female group.…”

Quantifying Urinary and Sexual Dysfunction After Pelvic Fracture

“…Given the long-term ramifications after pelvic fracture, the importance of the patients' perception of their functioning and quality of life after injury has increasingly received attention. 49,50 In a study of patients attending a dedicated pelvicand-acetabular reconstruction clinic because of blunt pelvic trauma, Harvey-Kelly et al 51 showed that male and female sexual functions were significantly decreased after 1 year, and sexual dysfunction was shown to be an independent risk factor for decreased quality of life after injury. Similarly, Odutola et al 28 indicated that urinary dysfunction and sexual dysfunction occurred in 41% and 43% of patients, respectively, but neither new urinary dysfunction nor sexual dysfunction was associated with gender or genitourinary injury.…”

Revisiting Non-operative Treatment of Lateral Compression Pelvic Fractures, Analysis of Rehabilitation, and Radiologic Outcomes in a Historical Cohort Using Today’s Association of Osteosynthesis (AO) Stability Criteria

“…On the other hand, stable and unstable fractures presented significant differences in TWI and TRW. This suggests that the 2018 AO criteria help identify patients in whom a nonoperative approach results in prolonged rehabilitation periods, though whether the surgical treatment of these unstable fractures improves outcomes remains unclear [19,[24][25][26][27][28][29].…”