Abstract
Introduction: The combination of ipsilateral femoral and acetabular fractures is known in the literature as the “Floating hip injury”. The primary aim of this study is to assess both generic and specific patient-reported outcomes and the factors affecting the quality of life in patients sustaining this injury, while the secondary aim was to assess the injury patterns and the associated complications. Methods: A retrospective study including 27 patients according to specific inclusion and exclusion criteria. EQ5D5L and Oxford hip score (OHS) were used. The mean age was 28 years (±10.1 SD) and 21 patients (77.8%) were males. The mean follow-up was 7 years (± 3.1 years SD). Results: Median OHS was 46.5 (IQR: 31.5–48). The median EQ5D score was 0.919 (95% CI: 0.601–1). The mean EQ5D index value was 0.679 ± 0.442 (95% CI: 0.492–0.865). In this young cohort of patients, this drop in the mean EQ5D index value has led to a loss of a mean of 2.2 Quality-adjusted Life Years (QALYs). Through multivariate analysis, we found that the quality of life was mainly affected by the occurrence of end-stage arthritis, the presence of non-recovered traumatic sciatic nerve injury, and the occurrence of infection. Conclusions: Our findings show that the quality of life of those patients was significantly affected. These findings can be beneficial in counselling patients sustaining this complex injury and could be helpful in the discussion of the prognosis and in planning postoperative rehabilitation and support.
Highlights
The combination of an ipsilateral femur and acetabular fracture is uncommon, and it has been estimated that the incidence is 1 in 10,000 [1, 2]
This study aimed primarily to evaluate the health-related quality of life (HRQoL) outcome of patients with ipsilateral femoral and acetabular fractures using combined generic and specific patient-reported outcome measures (PROMs) and secondarily was to assess the injury patterns and the associated complications
The analysis was retrospective, and the sample size is relatively small, but this can be expected given the rarity of the injury and given that this study reports the experience of a single Level I trauma centre
Summary
The combination of an ipsilateral femur and acetabular fracture is uncommon, and it has been estimated that the incidence is 1 in 10,000 [1, 2]. Tile [14] described two acetabular fracture mechanisms according to the direction of force applied: a “dashboard” type injury and a “side blow” injury to the greater trochanter. This classical biomechanical interpretation of acetabular fractures was never proven by laboratory studies. Liebergall et al [15] reinforced Tile’s observations and formulated a patho-mechanical classification, This study aimed primarily to evaluate the health-related quality of life (HRQoL) outcome of patients with ipsilateral femoral and acetabular fractures using combined generic and specific patient-reported outcome measures (PROMs) and secondarily was to assess the injury patterns and the associated complications
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