Session I - Polytrauma / Pelvis / Post-Traumatic Reconstruction

Thurs., 10/10/13 Polytrauma/Pelvis/Post-Trauma, PAPER #35, 4:12 pm OTA 2013

Patient-Reported Health After Surgically Treated Displaced Sacral Fractures: A 10-Year Follow-up

Aron Adelved, MD1,2; Anna Tötterman, MD, PhD3; Thomas Glott, MD4;
Helene Søberg, PT, PhD5; Jan Erik Madsen, MD, PhD2; Olav Røise, MD, PhD2;
1Orthopaedic Department, Akershus University Hospital, Lørenskog, Norway;
2Orthopaedic Department, Oslo University Hospital, Olso, Norway;
3Orthopaedic Department, Karolinska University Hospital, Stockholm, Sweden;
4Department for Spinal Cord Injury and Multitrauma, Sunnaas Hospital, Nesodden, Norway;
5Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway

Purpose: Displaced sacral fractures are associated with considerable morbidity. The aim of this study was to assess the long-term patient-reported health after surgically treated displaced sacral fractures, its association with clinical outcomes, and changes over time

Methods: Between 1996 and 2001, 32 consecutive patients with surgically treated displaced sacral fractures were included in a 1-year clinical outcome study, the results of which have been previously published. In the present study, 28 of these patients were available for follow-up, mean 10.7 years (range, 8.1-13.4) postinjury. Collected data included patient-reported health with Short Form-36 (SF-36), pain (visual analog scale), neurologic deficits in the lower extremities, and urinary, bowel, and sexual function. The SF-36 scores were compared to the Norwegian general population scores (NBS) and the previously published 1-year scores.

Results: At 10 years, the SF-36 scores were significantly lower than the NBS in all subscales. No significant changes were found between 1- and 10-year scores. We found significant correlations between pain and poor Physical Functioning (P = 0.05), Role Physical (P = 0.01), Bodily Pain (BP) (P = 0.003), General Health (P = 0.007), and Role Emotional (RE) (P = 0.006). Sexual dysfunction was significantly correlated with poor Social Functioning (P = 0.013) and RE (P = 0.04), and bowel dysfunctions with BP (P = 0.02) and poor RE (P = 0.03). No correlations were found between SF-36 and urinary dysfunction or neurologic deficits in the lower extremities.

Conclusion: Patients with displaced sacral fractures reported poor health at 10 years, compared to the general population, with no significant improvement between 1 and 10 years. Poor self-reported health was associated with pain and sexual and bowel dysfunctions. The strongest association was found between pain and patient-reported health, suggesting a special attention to pain treatment, in order to improve quality of life in these patients.

Alphabetical Disclosure Listing

• 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. Δ OTA Grant.