Functional outcome of patients with unstable pelvic ring fracture Comparison of short- and long-term prognostic factors

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 25; no. 1
• Main Authors: Kokubo, Yasuo, Oki, Hisashi, Sugita, Daisuke, Takeno, Kenichi, Miyazaki, Tsuyoshi, Negoro, Kohei, Nakajima, Hideaki
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2017
• Subjects: functional outcome; unstable pelvic ring fracture; multiple logistic regression analysis; long term; short-term; statistical analysis; risk factor
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/2309499016684322

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.