The Effect of Implant Failure After Symphyseal Plating on Functional Outcome and General Health

Frietman, Bas; Verbeek, Jan; Biert, J.; Frölke, Jan-Paul

doi:10.1097/bot.0000000000000501

Cited by 10 publications

(29 citation statements)

References 27 publications

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“…Thirty-eight studies [ 8 , 9 , 25 , 26 , 28 – 30 , 32 – 36 , 10 , 37 – 44 , 46 , 47 , 11 , 48 – 54 , 56 , 18 – 22 , 24 ] used a pelvic-specific PROM, either as a single instrument or in combination with a generic PROM. Generic PROMs for physical functioning and quality of life were used in 15 studies [ 8 , 10 , 39 , 40 , 46 , 57 , 58 , 12 , 13 , 15 , 17 , 19 , 23 , 27 , 30 ]. The follow-up moment when these questionnaires were assessed ranged from six months to 15 years after the injury.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 34 studies [ 8 , 9 , 26 , 28 – 30 , 32 – 37 , 10 , 39 , 41 , 43 , 44 , 46 – 51 , 11 , 52 – 54 , 19 – 22 , 24 , 25 ] that used the Majeed Pelvic Score (MPS), in 28 of them [ 9 , 11 , 32 – 38 , 41 , 43 , 44 , 20 , 47 – 54 , 21 , 22 , 24 – 26 , 28 , 29 ] it was the only outcome instrument used. Most studies described the results in terms of the clinical grade.…”

Section: Resultsmentioning

confidence: 99%

“…The SF-36 was used in seven studies [ 8 , 17 , 19 , 23 , 27 , 30 , 46 ]. Five studies [ 19 , 23 , 27 , 30 , 46 ] described all eight components of the SF-36 and one study [ 8 ] only described three of them. Scores ranged from 53 up to 69 (physical functioning), 24 to 71 (role physical), 49 to 68 (bodily pain), 42 to 65 (general health), 46 to 62 (vitality), 52 to 81 (social functioning), 49 to 85 (role emotional) and 52 to 78 (mental health).…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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Background Pelvic ring injuries are one of the most serious traumatic injuries with large consequences for the patients’ daily life. During recent years, the importance of the patients’ perception of their functioning and quality of life following injury has increasingly received attention. This systematic review reports on self-reported physical functioning and quality of life after all types of pelvic ring injuries. Methods The online databases MEDLINE-PubMed and Ovid-EMBASE were searched for studies published between 2008 and 2019 to identify published evidence of patient-reported physical functioning and quality of life after which they were assessed for their methodological quality. Results Of the 2577 articles, 46 were reviewed in full-text, including 3049 patients. Most studies were heterogeneous, with small cohorts of patients, a variety of injury types, treatment methods and use of different, often non-validated, outcome measures. The overall methodological quality was moderate to poor. Nine different PROMs were used, of which the Majeed Pelvic Score (MPS), SF-36 and EQ-5D were the most widely used. Mean scores respectively ranged from 75–95 (MPS), 53–69 (SF-36, physical functioning) and 0.63–0.80 (EQ-5D). Conclusions Physical functioning and quality of life following pelvic ring injuries seem fair and tend to improve during follow-up. However, differences in patient numbers, injury definition, treatment strategy, follow-up duration and type of PROMs used between studies hampers to elucidate the actual effects of pelvic ring injuries on a patient’s life. Implications of key findings Physicians and researchers should use valid and reliable patient-reported outcome instruments on large cohorts of patients with properly defined injuries to truly evaluate physical functioning and quality of life after pelvic ring injuries. Systematic review registration number PROSPERO International prospective register of systematic reviews; registration number CRD42019129176.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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“…Even though no patient reported outcome measures have been developed for pelvic trauma; generic outcome instruments (SF-36) and disease speci c instruments have been used to assess patient functional performance [25].…”

Section: Discussionmentioning

confidence: 99%

“…Giannoudis et al found no correlation of its occurrence with worse functional outcome [14]. On the other hand, Frietman et al [25] retrospectively evaluated 37 patients treated with anterior pelvic plating and reported higher Majeed scores and similar SF-36 scores in patients with implant failure. Conversely, we observed signi cant differences in mean Majeed scores of patients with and without FF (p = 0,012).…”

Section: Discussionmentioning

confidence: 99%

Fixation Failure in Patients With Traumatic Diastasis of Pubic Symphysis: Impact of Loss of Reduction on Early Functional Outcomes.

Ponce

Ewertz

Tropa

2021

Preprint

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BackgroundFailure of fixation (FF) in pubic symphysis diastasis (SD) ranges between 12 to 75%, though whether it influences functional outcomes is still debated. The objective of this study is to evaluate the impact of anterior pelvic plate failure and loss of reduction on Majeed`s functional scores. MethodsSingle center retrospective review of consecutive patients with acute SD treated by means of anterior pubic plating. Thirty seven patients with a mean age 45.7+/-14.4 years, were included. Demographics, AO classification, pelvic fixation and secondary procedures were recorded. Majeed´s functional scores at minimum 6 months followup were compared according to the presence of FF and loss of reduction. ResultsFifteen patients presented FF. Eight presented an additional loss of symphyseal reduction. Mean Majeed´s score (MMS) in patients with and without FF was 64,4+/-13,04 and 81.8+/-15.65 respectively (p=0.0012). Differences in MMS in patients without FF and those with FF and maintained or loss of anterior reduction were 11,3 [70,5vs81,8] (p=0,092) and 22.7 [59,1vs81,8] (p=0,001) respectively. Significant association of FF with AO classification was noted. (OR 12.6; p=0.002).ConclusionsDifferences in MMS in the analysed groups suggest that loss of reduction might be more relevant than failure of the anterior osteosynthesis in functional outcomes.

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Plate fixation of the anterior pelvic ring in patients with fragility fractures of the pelvis

Herteleer

Boudissa

Hofmann

et al. 2021

Eur J Trauma Emerg Surg

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Introduction In fragility fractures of the pelvis (FFP), fractures of the posterior pelvic ring are nearly always combined with fractures of the anterior pelvic ring. When a surgical stabilization of the posterior pelvis is performed, a stabilization of the anterior pelvis is recommended as well. In this study, we aim at finding out whether conventional plate osteosynthesis is a valid option in patients with osteoporotic bone. Materials and methods We retrospectively reviewed medical charts and radiographs of all patients with a FFP, who underwent a plate osteosynthesis of the anterior pelvic ring between 2009 and 2019. Patient demographics, fracture characteristics, properties of the osteosynthesis, complications and revision surgeries were documented. Single plate osteosynthesis (SPO) at the pelvic brim was compared with double plate osteosynthesis (DPO) with one plate at the pelvic brim and one plate anteriorly. We hypothesized that the number and severity of screw loosening (SL) or plate breakage in DPO are lower than in SPO. Results 48 patients with a mean age of 76.8 years were reviewed. In 37 cases, SPO was performed, in 11 cases DPO. Eight out of 11 DPO were performed in patients with FFP type III or FFP type IV. We performed significantly more DPO when the instability was located at the level of the pubic symphysis (p = 0.025). More patients with a chronic FFP (surgery more than one month after diagnosis) were treated with DPO (p = 0.07). Infra-acetabular screws were more often inserted in DPO (p = 0.056). Screw loosening (SL) was seen in the superior plate in 45% of patients. There was no SL in the anterior plate. There was SL in 19 of 37 patients with SPO and in 3 of 11 patients with DPO (p = 0.16). SL was localized near to the pubic symphysis in 19 of 22 patients after SPO and in all three patients after DPO. There was no SL in DPO within the first month postoperatively. We performed revision osteosynthesis in six patients (6/48), all belonged to the SPO group (6/37). The presence of a bone defect, unilateral or bilateral anterior pelvic ring fracture, post-operative weight-bearing restrictions, osteosynthesis of the posterior pelvic ring, and the presence of infra- or supra-acetabular screws did not significantly influence screw loosening in SPO or DPO. Conclusion There is a high rate of SL in plate fixation of the anterior pelvic ring in FFP. In the vast majority, SL is located near to the pubic symphysis. DPO is associated with a lower rate of SL, less severe SL and a later onset of SL. Revision surgery is less likely in DPO. In FFP, we recommend DPO instead of SPO for fixation of fractures of the anterior pelvic ring, which are located in or near to the pubic symphysis.

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The Effect of Implant Failure After Symphyseal Plating on Functional Outcome and General Health

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 10 publications

References 27 publications

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

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

Fixation Failure in Patients With Traumatic Diastasis of Pubic Symphysis: Impact of Loss of Reduction on Early Functional Outcomes.

Plate fixation of the anterior pelvic ring in patients with fragility fractures of the pelvis

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