Fri., 10/19/07 Pelvis, Paper #30, 11:54 am OTA-2007
Quality of Life following Pelvic and Acetabular Fractures
Tomas Borg, MD1 (n); Per Berg, MD1 (n); Sune Larsson, MD1, PhD (n);
Kerstin Fugl-Meyer, MD, PhD2 (n);
1Department of Surgical Sciences, University of Uppsala, Sweden;
2Center for Andrology and Sexual Medicine, Karolinska University Hospital, Stockholm, Sweden
Purpose: Pelvic and acetabular fractures are severe injuries for which radiologic and clinical outcome has been well described, while description from the patient’s perspective is less well documented. We wanted to evaluate this group of patients using quality of life instruments.
Methods: All patients with pelvic and acetabular fractures referred to our institution for surgical treatment in 2003 and 2004 were prospectively included. There were 102 patients (68 male, 34 female, aged 16-79 years) with 39 pelvic and 63 acetabular fractures. The most common trauma was motor vehicle accident (40%). Additional injuries were seen in 52%. 13 pelvic (33%) and 11 acetabular (17%) fracture patients had ISS ≥16. The most common fracture types were B2 pelvic and both-column acetabular. Surgical approach was open in 16, percutaneous in 9, and combined in 14 pelvic fractures. Kocher-Langenbeck was used in 22, ilioinguinal approach in 40 acetabular fractures, and both combined once. Patients were followed for 2 years using two validated questionnaires, SF-36 and LiSat-11. The latter is an instrument consisting of 11 questions used for evaluation of life satisfaction in different areas including sexuality.
Results: 84 patients answered the questionnaire, 3 were untraceable, and 3 died from unrelated causes. Out of 12 nonresponders, 7 were unable due to psychiatric disorder. At 2 years, both pelvic and acetabular fracture patients scored lower than the reference population in both physical and mental domains (SF-36). Highest mean score was in the domain Social Function, with 66 for pelvic and 75 for acetabular fractures, while lowest mean score was in the domain Role Physical with 34 and 46, respectively. In LiSat-11, both pelvic and acetabular fractures scored lower than the reference population in the sexual domain. 31% of pelvic and 34% of acetabular fractures reported satisfaction with sexual life compared to 58% in the reference population.
Conclusion and Significance: Still, at 2 years after surgical treatment of pelvic or acetabular fractures, patients reported substantially lowered quality of life for both physical and mental domains as well as with sexual life, even if radiologic or clinical outcome was considered as favorable. This highlights the need to involve other specialities during the course of rehabilitation for these severely injured fracture patients.
If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.
• The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an “off label” use). ◆FDA information not available at time of printing.