Ghosh Subhajit, Aggarwal Sameer, Kumar Prasoon, Kumar Vishal
Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Clin Orthop Trauma. 2019 Sep-Oct;10(5):896-899. doi: 10.1016/j.jcot.2018.08.001. Epub 2018 Aug 2.
Pelvic fractures are markers of high energy trauma and are associated with significant morbidity and mortality. With evolution of modern diagnostic tools and intervention their management has come a long way.
Whether or not modern healthcare could provide the victims of such high energy trauma with a good functional outcome and optimal quality of life, such that they are able to perform their activities of daily living independently?
To evaluate the functional outcomes in pelvic fractures and to find out factors that could indicate the prognosis.
Ours is a prospective observational study with 75 patients at a tertiary care hospital between September 2015 to December 2016. The minimum duration of follow up was six months. Patients' demographic profile, mode and pattern of injury, associated injuries, management and subsequent complications, if any were recorded prospectively. Functional outcomes were assessed using the Majeed score. All preoperative parameters were correlated statistically with the Majeed score to find out their association.
Majeed scores were excellent in 27 patients, good in 29 patients, fair in 12 patients and poor in 7 patients. Overall functional outcome were good due to availability of sophisticated diagnostic tools, dedicated trauma management team and experienced pelvi-acetabular surgeon. Poorer outcomes were seen in male gender, associated urogenital injuries, associated acetabulum and sacrum fractures, associated nerve injuries and bedsore. No association were seen with age, fracture pattern, treatment modality and timing of surgery.
With modern day diagnostic and therapeutic modalities the functional outcome a patient could achieve is promising. With associated risk factors guiding the outcome, the health care provider can individualise the management and decrease the overall morbidity and mortality of such high energy injuries.
骨盆骨折是高能量创伤的标志，与显著的发病率和死亡率相关。随着现代诊断工具和干预手段的发展，其治疗取得了长足进步。
现代医疗保健能否为这类高能量创伤的受害者提供良好的功能结局和最佳生活质量，使其能够独立进行日常生活活动？
评估骨盆骨折的功能结局，并找出可预示预后的因素。
我们进行了一项前瞻性观察性研究，于2015年9月至2016年12月在一家三级护理医院纳入了75例患者。最短随访时间为6个月。前瞻性记录患者的人口统计学资料、损伤方式和模式、相关损伤、治疗及后续并发症（如有）。使用马吉德评分评估功能结局。对所有术前参数与马吉德评分进行统计学相关性分析，以找出它们之间的关联。
27例患者马吉德评分优秀，29例良好，12例中等，7例较差。由于有先进的诊断工具、专业的创伤管理团队和经验丰富的骨盆髋臼外科医生，总体功能结局良好。男性、合并泌尿生殖系统损伤、合并髋臼和骶骨骨折、合并神经损伤和褥疮患者的结局较差。未发现与年龄、骨折类型、治疗方式和手术时机有关联。
借助现代诊断和治疗方式，患者可实现的功能结局很有前景。鉴于相关风险因素可指导结局，医疗保健提供者可实施个体化治疗，降低此类高能量损伤的总体发病率和死亡率。
