Abstract
Purpose
The measurement of functional outcomes in pelvic fracture patients remains difficult for authors. We aimed to test the construct validity, respondent burden, and patient perception of three previously published pelvic outcome questionnaires.
Method
Subjects completed three pelvic specific, and three general functional outcome instruments. Time for each pelvic instrument was recorded, as was which score the patient felt best addressed their symptoms. Patients stated the three most significant impacts the pelvic fracture had on their life.
Results
We recruited 33 patients, who were a mean of 61 months from surgery (13–115 months). Mobility difficulty (26), emotional stress (20), employment difficulty (15), sleep and anxiety (7), sexual function (4), were the most important consequences of their injuries. All pelvic questionnaires correlated with the physical component summary of the SF-36 (Majeed 0.877, Iowa 0.876, Orlando 0.868). None correlated with the mental component summary. The Iowa and Majeed questionnaires demonstrated ceiling effects, with 24% and 21% having the highest possible scores. Time was 3.6 + 0.4 minutes (Iowa), 7.4 + 0.4 (Orlando) and 2.6 + 0.2 (Majeed). Twelve patients each preferred the Iowa and Orlando, and 9 preferred the Majeed.
Conclusion
All three previously published pelvic outcome instruments demonstrated strong construct validity with high correlation the PCS the SF-36, but ceiling effects and respondent burden limit the utility of the current instruments. Mental and emotional outcomes were important consequences of the injuries; however, none of the pelvic questionnaires measure these domains, as they all correlate poorly with the MCS of the SF-36.
