Quality of life after pelvic ring injuries: follow-up results of a prospective study

Abstract

A follow-up after 2 years on average could be done in 43 cases of pelvic ring injuries. Seven were type A, 8 type B and 28 type C lesions. Every type A lesion was treated non-operatively. External fixation and non-operative management were used with type B injuries. As well as non-operative treatment, both internal and external surgical techniques were employed for type C fractures. While group A hardly mentioned pain in the follow-up, groups B and C suffered dorsal pelvic pain of comparable intensity irrespective of the therapeutic measures taken. Anatomic reduction does not guarantee freedom from pain. We also rated hip joint flexibility and ability to walk according to the Merle D'Aubigné score. Because of their pelvic injuries 50% of the type C patients changed their profession. The sequelae of the accident on sports and leisure time activities will be considered as well as the subjective contentment evaluated. Unstable and dislocated pelvic ring injuries permanently interfere to a high degree with the quality of life. It is remarkable that many of the traumatic lesions which interfere with the quality of life are caused by the traumatic violence itself and cannot be influenced by the manner of surgical stabilization.

High Rates of Sexual and Urinary Dysfunction After Surgically Treated Displaced Pelvic Ring Injuries

“…However, our findings were LC type injury was least likely and VS type most likely to result in sexual dysfunction, with similar findings for urinary dysfunction. These findings are supported by a previous German study [28] using the Tile classification [40], which reported higher rates of sexual dysfunction in Type B1 than B2 fractures and in Type C than B2 injuries, as well as other studies showing greater instability associated with more sexual complaints and less recovery [16,28,29,34]. However, there are conflicting reports, with other studies finding no apparent relationship of pelvic fracture type and sexual dysfunction in males [25,31] or females [3,9,11].…”

A Minimally Invasive Stabilizing System for Dorsal Pelvic Ring Injuries

“…In one prospective study including 28 Type C lesions, no or slight pain was present in 50% of patients, moderate pain was present in 43%, and severe pain was present in only 7% [7]. However, half of all patients in this group had to change their profession because of their pelvic ring injuries [7]. Comparable findings were reported by Pohlemann et al [27], with a followup of 21 patients with Type C injuries.…”

“…Therefore, we believe the short operative duration and marginal blood loss are advantages of the TIFI. In one prospective study including 28 Type C lesions, no or slight pain was present in 50% of patients, moderate pain was present in 43%, and severe pain was present in only 7% [7]. However, half of all patients in this group had to change their profession because of their pelvic ring injuries [7].…”

“…The majority of surviving patients consider their quality of life as mediocre or worse [7,10,17,39], and the treatment often is challenging for the surgeon.…”

“…Minimally invasive, percutaneous procedures minimize soft tissue injury but the risk of iatrogenic neurovascular lesions is not negligible. Furthermore anatomic reduction does not guarantee patient satisfaction [7]. Long-term problems associated with operatively treated pelvic ring injuries include various complications such as pain, restrictions in activities of daily life, sexual dysfunction, or urinary system complaints [27].…”