Long-term outcome in patients with combined spinal and pelvic fractures

The outcome of 30 patients with combined spinal and pelvic fractures (C group) was retrospectively investigated and compared with matched group of similar number of isolated spinal fractures (S group) and isolated pelvic fractures (P Group), admitted to our institution between Jan 1998 and May 2002, following a high-energy trauma. After a mean follow-up of 57 months their outcomes were studied using EuroQol questionnaire and return to work status. The EQ-5D scores for patients in the S group were 0.71 (SD 0.29) compared to 0.60 (SD 0.14) for patients in the P group and 0.63 (SD 0.23) for patients in the C group. The EQ-VAS scores were similarly favourable towards patients in the S group. Seventy percent of patients in the S group returned to their previous level of employment after a mean duration of 5.3 months compared to 55% in the P group and 57% in the C group after a mean duration of 9.4 months and 12.8 months, respectively. Patients with isolated spinal fractures had an overall satisfactory outcome compared with patients in the other 2 groups. However, no difference was noted while analysing the outcomes in the later 2 groups (p<0.05), suggesting that the pelvic fracture contributes to the poor outcome, and the presence of a spinal fracture does not influence the long-term outcome. However, problems related to associated injuries and motor neurological deficits have profound confounding effect on the outcome in all 3 groups.