FUNCTIONAL OUTCOME OF PATIENTS WITH UNSTABLE PELVIC FRACTURES

Abstract

Much interest and controversy have arisen regarding treatment and prognosis of unstable pelvic fractures. The choice of treatment should be based to a large extent on the long-term outcome. Residual vertical displacement and sacroiliac joint involvement are often cited as being related to poor outcome. This study attempts to clarify whether residual vertical displacement or location of posterior pelvic ring injury correlate with functional outcomes.

33 patients with unstable pelvic fractures not involving the acetabulum were reviewed with greater than 18 months of follow-up. Iowa pelvic scores and descriptive information about sequelae were administered. Fractures were classified according to Tile as 27 type B, and 6 type C fractures. 9 cases were treated with external fixation and 5 cases were treated open reduction and internal fixation. The amount of residual vertical displacement was measured on plain AP radiographs and graded as 0–4,4–10,10–20, or > 20mm. Location of posterior pelvic ring injury was divided into 3 groups, sacral fractures, sacroiliac fracture dislocations, and transiliac fractures.

Residual vertical displacement correlated with the incidence of LBP to some extent, but the difference was not statistically significant. Location of the posterior pelvic injury correlated with the incidence of neurologic injury and gait disturbance.

There was high incidence of lower extremity fractures associated with the pelvic fractures. The incidence of gait disturbance and Iowa pelvic score were not valid as functional assessment tool.

Residual vertical displacement and location of posterior pelvic injury correlated with the functional outcome to some extent.