Department of Orthopedic Surgery, Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou Branch, and Chang Gung University, Tao-Yuan, Taiwan. 5, Fu-Hsin St. Kweishan, 33302, Tao-Yuan, Taiwan.
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan Branch, Tao-Yuan City, Taiwan.
World J Surg. 2022 Mar;46(3):568-576. doi: 10.1007/s00268-021-06386-9. Epub 2022 Jan 1.
Data on the functional outcomes of patients with open pelvic fractures after osteosynthesis are limited, and whether open fracture is a risk factor for worse outcomes, as compared with closed fracture, remains unclear. This study aimed to compare the functional outcomes of patients with open and closed pelvic fractures and evaluate potential factors that might affect outcomes.
Overall, 19 consecutive patients with open pelvic fractures and 78 patients with closed pelvic fractures between January 2014 and June 2018 were retrospectively reviewed. All fractures were surgically treated, with a minimal follow-up period of three years. Patients' demographic profile, associated injuries, management protocol, quality of reduction, and outcomes were recorded and analyzed.
Patients with open pelvic fractures had higher new injury severity score, higher incidence of diverting colostomy, and longer length of stay. Both radiological and functional evaluations revealed no significant differences between the two groups at 1-year and 3-year evaluations. Multiple logistic regression analysis identified poor radiological outcomes (using Lefaivre criteria) and longer length of stay as risk factors for worse short-term functional outcomes. At 3-year evaluation, fair-to-poor radiological outcomes (using Matta/Tornetta and Lefaivre criteria) and the presence of diverting colostomy were potential risk factors.
Compared with closed pelvic fracture, open pelvic fracture was not an indicator of worse functional outcomes. Functional outcomes may be comparable between patients with open and closed pelvic fractures at different time points within three years postoperatively. Achieving anatomical reduction in a fracture is crucial, because it might affect patient satisfaction.
有关骨盆开放性骨折患者内固定术后功能结局的数据有限，且与闭合性骨折相比，开放性骨折是否为导致较差结局的危险因素尚不明确。本研究旨在比较开放性和闭合性骨盆骨折患者的功能结局，并评估可能影响结局的潜在因素。
回顾性分析了 2014 年 1 月至 2018 年 6 月期间连续收治的 19 例开放性骨盆骨折患者和 78 例闭合性骨盆骨折患者。所有骨折均采用手术治疗，随访时间至少 3 年。记录并分析患者的人口统计学特征、合并伤、处理方案、复位质量和结局。
开放性骨盆骨折患者的新损伤严重程度评分更高、结肠造口术发生率更高、住院时间更长。在 1 年和 3 年评估时，两组的影像学和功能评估结果均无显著差异。多因素逻辑回归分析显示，影像学结局较差（采用 Lefaivre 标准）和住院时间较长是短期功能结局较差的危险因素。在 3 年评估时，影像学结局较差（采用 Matta/Tornetta 和 Lefaivre 标准）和结肠造口术的存在是潜在的危险因素。
与闭合性骨盆骨折相比，开放性骨盆骨折并非功能结局较差的指标。在术后 3 年内的不同时间点，开放性和闭合性骨盆骨折患者的功能结局可能相似。实现骨折的解剖复位至关重要，因为这可能影响患者满意度。
