Persistent impairment after surgically treated lateral compression pelvic injury

Area of Science:

• Orthopedic surgery
• Traumatology
• Rehabilitation medicine

Background:

• Lateral compression (LC) pelvic fracture fixation is increasingly used for improved patient comfort and early mobilization.
• However, the extent of acceptable residual deformity and persistent functional deficits after LC fixation remain unclear.

Purpose of the Study:

• To evaluate the influence of injury pattern, demographics, posterior displacement, L5/S1 involvement, associated injuries, and time on outcomes.
• Specifically assessing sexual dysfunction and pain following surgical treatment of unstable LC pelvic fractures.

Main Methods:

• Retrospective review of 119 patients with unstable LC pelvic injuries treated surgically (2000-2010).
• Data collected included demographics, injury characteristics, clinical examination, radiographic imaging, and Short Musculoskeletal Function Assessment (SMFA) scores.
• Minimum follow-up was 12 months (mean 33 months).

Main Results:

• Injury pattern and demographics did not significantly affect SMFA subscores.
• 83% of patients had <5 mm posterior displacement; 5-10 mm displacement did not impact SMFA scores.
• Associated lower extremity injuries correlated with worse SMFA scores; function improved over time.
• A visual analog scale pain score ≥4 at 6 months predicted later pain and overall SMFA scores.

Conclusions:

• Unstable LC pelvic ring injuries are associated with persistent disability, even with near-anatomical reduction.
• Patients should be counseled regarding the potential for some degree of ongoing functional limitation.
• Further studies with high follow-up rates are needed to confirm these findings.