Functional outcomes in pelvic fractures and the factors affecting them- A short term, prospective observational study at a tertiary care hospital.

BACKGROUND

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.

RESEARCH QUESTION

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?

OBJECTIVES

To evaluate the functional outcomes in pelvic fractures and to find out factors that could indicate the prognosis.

METHODOLOGY

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.

RESULTS

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.

CONCLUSION

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.