Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
J Orthop Trauma. 2019 Dec;33(12):608-613. doi: 10.1097/BOT.0000000000001588.
Describe the trajectory of functional recovery for patients with surgically treated unstable pelvic ring injuries from baseline to 5 years.
Prospective cohort study.
Level I Trauma Center.
PATIENTS/PARTICIPANTS: One hundred eight adult patients with surgically treated pelvic fractures (72% OTA/AO 61 B1-B3 and 28% OTA/AO 61 C1-C3) were enrolled into the institutions orthopaedic trauma database between 2004 and 2015. The cohort was 78% men with a mean age of 44.9 years and injury severity score of 16.9.
Surgical pelvic stabilization.
Function was measured at baseline and prospectively at 6 months, 1, and 5 years postoperatively using the Short Form-36 Physical Component Score (SF-36 PCS). The trajectory was mapped, and the proportion of patients achieving a minimal clinically important difference (MCID) between time points was determined.
The mean SF-36 PCS improved for the entire group between 6 and 12 months (P = 0.001) and between 1 and 5 years (P = 0.02), but did not return to baseline at 5 years (P < 0.0001). The proportion of patients achieving a MCID between 6 and 12 months and 1 and 5 years was 75% and 60%, respectively. The functional level was similar between type B and C groups at baseline (P = 0.5) and 6 months (P = 0.2); however, the type B cohort reported higher scores at 1 year (P = 0.01) and 5 years (P = 0.01). Neither group regained their baseline function (P < 0.0001).
Functional recovery for patients with surgically treated pelvic fractures is characterized by an initial decline in function, followed by sharp improvement between 6 and 12 months, and continued steady improvement between 1 and 5 years. Type B injuries show better early recovery than type C and reach a higher level of function at the final follow-up. Despite the proportion of patients achieving MCID, patients do not regain the preinjury level of function.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
描述手术治疗不稳定骨盆环损伤患者从基线到 5 年的功能恢复轨迹。
前瞻性队列研究。
一级创伤中心。
患者/参与者：2004 年至 2015 年期间，共有 108 例接受手术治疗骨盆骨折的成年患者（72%为 OTA/AO 61 B1-B3 型，28%为 OTA/AO 61 C1-C3 型）被纳入机构骨科创伤数据库。队列中 78%为男性，平均年龄为 44.9 岁，损伤严重程度评分为 16.9。
手术骨盆稳定。
使用简明 36 项健康调查量表（SF-36）生理成分评分（PCS），分别于基线和术后 6 个月、1 个月和 5 年进行前瞻性功能测量。绘制轨迹图，并确定各时间点达到最小临床重要差异（MCID）的患者比例。
整个组的 SF-36 PCS 在 6 至 12 个月（P=0.001）和 1 至 5 年（P=0.02）之间均有改善，但在 5 年时未恢复到基线水平（P＜0.0001）。在 6 至 12 个月和 1 至 5 年之间，达到 MCID 的患者比例分别为 75%和 60%。B 型和 C 型组在基线（P=0.5）和 6 个月（P=0.2）时功能水平相似；然而，B 型组在 1 年（P=0.01）和 5 年（P=0.01）时报告的评分更高。两组均未恢复到基线功能（P＜0.0001）。
手术治疗骨盆骨折患者的功能恢复特点为功能最初下降，随后在 6 至 12 个月之间急剧改善，在 1 至 5 年之间持续稳定改善。B 型损伤的早期恢复优于 C 型，在最终随访时达到更高的功能水平。尽管达到 MCID 的患者比例较高，但患者无法恢复到受伤前的功能水平。
预后 III 级。有关证据水平的完整描述，请参阅作者说明。
