A retrospective study about functional outcome and quality of life after surgical fixation of insufficiency pelvic ring injuries

Katharina Jäckle; Marc-Pascal Meier; Mark-Tilmann Seitz; Sebastian Höller; Christopher Spering; Mehool R Acharya; Wolfgang Lehmann

doi:10.1186/s12891-021-04925-y

A retrospective study about functional outcome and quality of life after surgical fixation of insufficiency pelvic ring injuries

BMC Musculoskelet Disord. 2021 Dec 13;22(1):1035. doi: 10.1186/s12891-021-04925-y.

Authors

Katharina Jäckle¹, Marc-Pascal Meier², Mark-Tilmann Seitz², Sebastian Höller², Christopher Spering², Mehool R Acharya³, Wolfgang Lehmann²

Affiliations

¹ Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany. katharina.jaeckle@med.uni-goettingen.de.
² Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany.
³ Pelvic and Acetabular Reconstruction Unit, Department of Trauma & Orthopaedics, North Bristol NHS Trust, Southmead Hospital, Southmead Rd, Bristol, BS10 5NB, UK.

Abstract

Background: Fragility fractures without significant trauma of the pelvic ring in older patients were often treated conservatively. An alternative treatment is surgery involving percutaneous screw fixation to stabilize the posterior pelvic ring. This surgical treatment enables patients to be mobilized quickly and complications associated with bedrest and temporary immobility are reduced. However, the functional outcome following surgery and quality of life of the patients have not yet been investigated. Here, we present a comprehensive study addressing the long-term well-being and the quality of life of patients with fragility pelvic ring fractures after surgical treatment.

Methods: Between 2011-2019, 215 geriatric patients with pelvic ring fractures were surgically treated at the university hospital in Göttingen (Germany). Of these, 94 patients had fragility fractures for which complete sets of computer tomography (CT) and radiological images were available. Fractures were classified according to Tile and according to the FFP classification of Rommens and Hofmann. The functional outcome of surgical treatment was evaluated using the Majeed pelvic score and the Short Form Health Survey-36 (SF-36).

Results: Thirty five tile type C and 48 type B classified patients were included in the study. After surgery eighty-three patients scored in average 85.92 points (± 23.39) of a maximum of 100 points using the Majeed score questionnaire and a mean of 1.60 points on the numerical rating scale ranging between 0 and 10 points where 0 points refers to "no pain" and 10 means "strongest pain". Also, the SF-36 survey shows that surgical treatment positively effects patients with respect to their general health status and by restoring vitality, reducing bodily pain and an increase of their general mental health.

Conclusions: Patients who received a percutaneous screw fixation of fragility fractures of the posterior pelvic ring reported an overall positive outcome concerning their long-term well-being. In particular, older patients appear to benefit from surgical treatment.

Trial registration: Functional outcome and quality of life after surgical treatment of fragility fractures of the posterior pelvic ring, DRKS00024768. Registered 8th March 2021 - Retrospectively registered. Trial registration number DRKS00024768 .

Keywords: Fragility fractures; Long-term outcome; Percutaneous screw fixation; Quality of life.

MeSH terms

Aged
Bone Screws
Fracture Fixation, Internal / adverse effects
Fractures, Bone* / diagnostic imaging
Fractures, Bone* / surgery
Humans
Pelvic Bones* / diagnostic imaging
Pelvic Bones* / surgery
Quality of Life
Retrospective Studies
Treatment Outcome