Long-term functional outcome after unstable pelvic ring fracture.

PURPOSE: In patients with unstable pelvic ring fractures, the factors related to poor outcome are still controversial. The purpose of our study was to evaluate the long-term functional outcome of patients with unstable pelvic ring fractures and correlate it with various other factors.

METHODS: Fifty-seven patients who had a minimal follow-up of 2 years completed the three-view plain radiographs, physical examination, and functional assessment with questionnaire. There were 28 male and 29 female patients with an average age of 42.4 years and Injury Severity Score of 24.6 points. The mean time of follow-up was 47.2 months. Thirty-nine patients were Tile type B, and 18 were type C. Twenty-three patients were treated conservatively, 22 with external fixation, and 12 with internal fixation. The results were scored with the Majeed score, the Iowa Pelvic Score, and the Medical Outcomes Study Short-Form 36-item Health Survey (SF-36). Statistical analysis was performed by use of the Pearson correlation coefficient test and multiple regression analysis.

RESULTS: The average Majeed score was 79.7, the average IPS was 80.7, and the average physical component summary of the SF-36 was 13.4 points worse than that of the population norm. These scores correlate significantly with each other. The average residual displacement was 7.3 mm anteriorly and 5.2 mm posteriorly. Multiple regression analysis revealed that the Majeed score and the physical component summary of the SF-36 correlated with the presence of neurologic injury, and the Iowa Pelvic Score correlated with the presence of a mental disorder, posterior displacement, and neurologic injury.

CONCLUSIONS: The long-term functional outcome after unstable pelvic ring fracture was not associated with Injury Severity Score, fracture location or fracture type. We discovered a close correlation between neurologic injury and functional outcome.