Long-term functionality and quality of life after open pelvic ring fractures

Open pelvic fractures are rare, life-threatening injuries typically resulting from high-energy trauma. While acute management has improved, data on long-term functional outcomes and quality of life remain limited.

We retrospectively analyzed patients treated for open pelvic fractures with a minimum follow-up of 24 months. Demographic, clinical, and surgical data were collected. Functional outcomes were assessed using the Majeed Pelvic Score, and quality of life was evaluated using the Short Form-36 and EuroQol (EQ-5D-3L) questionnaires. We also assessed patient satisfaction, work capacity, and urogenital dysfunction. Predictive factors were identified through univariate and multivariate analyses. Radiographic evaluations were performed at the final follow-up.

Forty-one patients were evaluated at a mean follow-up of 95.4 months (range 24-223). Physical aspects of quality of life were significantly impaired, whereas mental and social domains were largely preserved. Most patients had satisfactory functional outcomes, although 25% showed poor function. Anatomical fracture reduction was associated with better outcomes, while neurological deficits predicted poorer recovery. The severity of initial soft tissue injury did not significantly influence long-term functional outcomes.

Open pelvic fractures lead to lasting physical impairment. Functional recovery is primarily determined by the quality of fracture reduction and the presence of neurological deficits. Once the acute phase has resolved, the extent and location of soft tissue injuries have limited prognostic value.