Abstract
Introduction
Pelvic fractures are indicators of severe trauma and high energy absorption. They are associated with multiple local or distant concomitant injuries, which explain their high mortality and morbidity. The aim of this study is to investigate the late sequel of traumatic-pelvic-fractures (PFX) focusing on quality-of-life and sexual-function.
Methods
From a database of prospectively documented data, patients who had suffered a PFX and had been treated operatively in our institution from January 2008–2009 were recruited. Exclusion criteria were patients less than one-year post-injury, pathological-fractures, patients < 18 or >65, and patients with co-morbidities linked to sexual dysfunction. Demographics, injury-mechanisms, fracture-patterns (Young-Burgess classification), injury-severity-score (AIS/05-ISS), urogenital injuries and clinical outcome were recorded and analysed. Health-related-quality-of-life was assessed using the (EuroQol-5D) and sexual-function using the international-index-of-erectile-function and the female-sexual-function-index. The minimum follow-up was 12 months (12–30).
Results
Out of 85 patients that met the inclusion criteria, 67 patients (24 females) with a mean age of 44 years (19–65) consented to participate in this study. Their mean ISS was 25(9–58), while 5(7.4%) had isolated PFX. There was shown to be a significant decrease in quality-of-life (p< 0.0001) and sexual-function (p< 0.0001). The decrease was significant in all 5 EQ5D domains with mobility, usual activities, and pain as the most significantly affected (p< 0.0001). 50.7% (34) patients reported a significant (p< 0.0001) decrease in their post-injury sexual function score (55.5%males, 47.8%females). Linear-regression showed urinary tract injury to be an independent risk factor for sexual dysfunction (p< 0.0001), while a Mann-Whitney-U-test identified that the PFX severity (VS-AP3-LC3-CMI vs. LC1-LC2-AP1-AP2-ILBL) correlated to sexual dysfunction (p=0.0463).
Conclusion
Both genders, irrespective of age-subgroups, suffering a PFX severe enough to undergo surgery, are at risk of a significant decrease of their quality-of-life and sexual-function. The presence of certain fracture types and urinary tract injuries can be used as predictors of late morbidity and early multidisciplinary management.
