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Published on: November 8, 2024
Patient-reported health minimum 8 years after operatively treated displaced sacral fractures: a prospective cohort
Aron Adelved1, Anna Tötterman, Thomas Glott
1*Department of Orthopaedic Surgery, Oslo University Hospital, Ullevaal, Oslo, Norway; †Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway; ‡Department of Orthopaedic Surgery, Karolinska University Hospital, Stockholm, Sweden; §Department of Spinal Cord Injury and Multitrauma Unit, Sunnaas Hospital, Nesodden, Norway; ‖Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevaal, Oslo, Norway; ¶Faculty of Medicine, University of Oslo, Oslo, Norway; and **Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
Objectives:
To assess long-term patient-reported health (PRH) after displaced sacral fractures, its association with clinical outcomes, and changes over time.
Design:
Prospective, longitudinal single-cohort study.
Setting:
Level I trauma center.
Patients/Participants:
From 1996 to 2001, 31 consecutive patients with operatively treated displaced sacral fractures participated in a 1-year follow-up. Twenty-eight of them were available for the present long-term follow-up of mean 10.7 years (range, 8.1-13.4) postinjury.
Intervention:
Surgical treatment with open or closed reduction and internal fixation.
Main Outcome Measures:
PRH was the main outcome, determined by the Short Form-36 (SF-36). Data were also collected on pain (using a visual analog scale), bladder function, neurologic deficits in the lower extremities, bowel function, sexual function, activities of daily living, and employment status. SF-36 scores from the present study were compared with norm-based scores for the Norwegian general population and 1-year scores.
Results:
At the present follow-up, mean 10.7 years (range, 8.1-13.4) postinjury, SF-36 scores were significantly lower than norm-based scores for all domains except mental health. No significant changes were observed between 1-year scores and scores from the present study. Pain correlated significantly with poor scores in the domains physical functioning (P = 0.05), role physical (P = 0.01), bodily pain (P = 0.003), general health (P = 0.007), and role emotional (P = 0.006). Sexual dysfunction correlated with poor social functioning (P = 0.013) and poor role emotional (P = 0.04); and bowel dysfunction with bodily pain (P = 0.02) and poor role emotional (P = 0.03). No correlations were found between SF-36 scores and bladder dysfunction or neurologic deficits.
Conclusions:
Patients with displaced sacral fractures reported poor PRH, mean 10.7 years after the initial injury, with no significant improvement compared with 1-year follow-up. A significant association was found between pain and PRH.
Level Of Evidence:
Therapeutic level IV. description of levels of evidence.
