Abstract
Introduction and Aims: To analyse the long-term functional outcome of vertical shear fractures to other forms of severe pelvic injuries: APC-III, LC-III, and complex acetabular fractures.
Method: Out of 561 patients with pelvic ring injuries we identified 31 vertical shear fractures in 29 consecutive patients. We selected 34 patients with APC–III, 32 patients with LC-III and 32 patients with complex (at least bicolumnar) acetabular fractures to form the control group, who were matched for age and sex with the vertical shear fracture group. The mean follow-up was 62 months. Functional outcome was assessed in all patients using the following generic outcome measurement tools: EuroQol – EQ 5D, SF36 v2 (Short form), VAS, SMFA (Short musculoskeletal functional assessment) and Majeed score. In addition, Merle d’Aubigné-Postel scores (Matta, 1986) and radiologic degenerative hip scores (Matta 1994) were used to assess patients with acetabular fractures.
Results: The mean age of all the patients in the study was 43.5 years (16–71) and the median injury severity score was 22 (12–32). All patients had their pelvic ring stabilised at least temporarily within 24 hours and all acetabular fractures were reduced and stabilised by seven days. Functional outcome was assessed in all patients of the control group and in 28/29 patients of the vertical shear fracture group. In the vertical shear fracture group, 35% of the patients have returned to their previous jobs (49% in control group), 30% have changed their professions (30% in control group) and 25% (14% in control group) have retired from regular work. In the acetabular group, 10 (31%) patients had neurologic injury (six sciatic, three common peroneal, one femoral). Of these, four were iatrogenic. Six patients had complete neurologic recovery. Heterotopic ossification was seen in 19 (59%) patients. Three patients (9%) with acetabular fractures (all had associated posterior wall fracture) had total hip replacements at 29, 40, 51 months. The clinical outcome of patients in the acetabular fracture group was: five excellent (three THA), four good, 13 fair and 10 poor.
The radiologic score of degenerative hip disease (Matta 1994) for the acetabular fracture group was: four excellent, eight good, 14 fair and three poor. Analysis of the functional outcome is shown in Table 1.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
None of the authors is receiving any financial benefit or support from any source.
