Elhence Abhay, Netaji Jeshwanth, Yadav Sandeep Kumar, Rajnish Rajesh Kumar, Gupta Saurabh
Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, India.
Department of Orthopaedics, Ganga Hospital, Coimbatore, India.
Eur J Orthop Surg Traumatol. 2024 May;34(4):1917-1925. doi: 10.1007/s00590-024-03869-y. Epub 2024 Mar 9.
Pelvic ring fractures, particularly those involving the posterior pelvis, pose significant challenges due to their inherent instability. The posterior pelvic ring is critical in providing structural support and stability to the pelvis. This study evaluates the functional outcomes and health-related Quality of life (HRQOL) of patients who underwent internal fixation for unstable pelvic fractures. Various factors influencing the outcomes are also investigated.
A single-center cross-sectional study was conducted on patients with unstable sacral fractures treated with posterior tension band plate or sacroiliac plating with or without symphyseal plating between 2016 and 2020. Patient demographics, injury mechanisms, associated injuries, surgical details, complications, and return-to-work data were collected. HRQOL was assessed using specific pelvic fracture instruments and general HRQOL questionnaires. Logistic regression analysis was performed to identify factors associated with lower SF-12 and SF-36 scores RESULTS: The study included 54 patients, predominantly males (55.6%), aged 18-70 years, with high-energy trauma mechanisms, such as road traffic accidents and occupational injuries. The majority of patients had lateral compression pelvic fractures. Overall, the functional outcomes were favorable, with excellent or good outcomes observed in 86.1% of cases. Patients with associated injuries, such as abdominal, chest, or head injuries, were likelier to have lower SF-12 physical component scores. Sexual satisfaction scores remained stable for most patients post-surgery.
This study highlights the favorable functional outcomes and HRQOL for patients undergoing fixation for unstable pelvic ring fractures. Younger, working-age males were the most commonly affected demographic. Associated injuries significantly affected physical HRQOL scores. Despite high-energy trauma, patients generally reported satisfactory sexual function post-surgery.
骨盆环骨折，尤其是涉及骨盆后部的骨折，因其固有的不稳定性而带来重大挑战。骨盆后环对于为骨盆提供结构支撑和稳定性至关重要。本研究评估了接受不稳定骨盆骨折内固定治疗患者的功能结局和与健康相关的生活质量（HRQOL）。还研究了影响结局的各种因素。
对2016年至2020年间接受后路张力带钢板或骶髂关节钢板固定（有或无耻骨联合钢板固定）治疗的不稳定骶骨骨折患者进行了单中心横断面研究。收集了患者的人口统计学资料、损伤机制、相关损伤、手术细节、并发症和重返工作岗位数据。使用特定的骨盆骨折工具和一般HRQOL问卷评估HRQOL。进行逻辑回归分析以确定与较低的SF - 12和SF - 36评分相关的因素。结果：该研究纳入了54例患者，主要为男性（55.6%），年龄在18 - 70岁之间，损伤机制多为高能量创伤，如道路交通事故和职业伤害。大多数患者为侧方压缩型骨盆骨折。总体而言，功能结局良好，86.1%的病例观察到优良结局。伴有腹部、胸部或头部等相关损伤的患者更有可能具有较低的SF - 12身体成分评分。大多数患者术后性功能满意度评分保持稳定。
本研究强调了接受不稳定骨盆环骨折固定治疗患者的良好功能结局和HRQOL。年龄较轻、处于工作年龄段的男性是最常受影响的人群。相关损伤显著影响身体HRQOL评分。尽管是高能量创伤，但患者术后普遍报告性功能令人满意。
