Abstract
BackgroundData on the functional outcomes of patients with open pelvic fractures after osteosynthesis are limited, and whether open fracture is a risk factor for worse outcomes, as compared with closed fracture, remains unclear. This study aimed to compare the functional outcomes of patients with open and closed pelvic fractures and evaluate potential factors that might affect outcomes.MethodsOverall, 19 consecutive patients with open pelvic fractures and 78 patients with closed pelvic fractures between January 2014 and June 2018 were retrospectively reviewed. All fractures were surgically treated, with a minimal follow-up period of three years. Patients’ demographic profile, associated injuries, management protocol, quality of reduction, and outcomes were recorded and analyzed.ResultsPatients with open pelvic fractures had higher new injury severity score, higher incidence of diverting colostomy, and longer length of stay. Both radiological and functional evaluations revealed no significant differences between the two groups at 1-year and 3-year evaluations. Multiple logistic regression analysis identified poor radiological outcomes (using Lefaivre criteria) and longer length of stay as risk factors for worse short-term functional outcomes. At 3-year evaluation, fair-to-poor radiological outcomes (using Matta/Tornetta and Lefaivre criteria) and the presence of diverting colostomy were potential risk factors.ConclusionsCompared with closed pelvic fracture, open pelvic fracture was not an indicator of worse functional outcomes. Functional outcomes may be comparable between patients with open and closed pelvic fractures at different time points within three years postoperatively. Achieving anatomical reduction in a fracture is crucial, because it might affect patient satisfaction.
Highlights
Pelvic fractures account for 1%–3% of all skeletal injuries, and the management remains challenging for orthopedic surgeons [1]
Patients with open pelvic fractures had higher new injury severity score, higher incidence of diverting colostomy, and longer length of stay. Both radiological and functional evaluations revealed no significant differences between the two groups at 1-year and 3-year evaluations
Functional outcomes may be comparable between patients with open and closed pelvic fractures at different time points within three years postoperatively
Summary
Pelvic fractures account for 1%–3% of all skeletal injuries, and the management remains challenging for orthopedic surgeons [1]. Significant functional morbidities and a relatively high rate of mortality, ranging from 10 to 16%, may be hypothetically associated with pelvic fractures [2,3,4]. Several studies have reported that various factors, such as fracture type, sex, age, injury severity score, associated injuries, surgical method, and quality of reduction, might affect post-injury functional outcomes [9,10,11,12,13,14,15]. Data on the functional outcomes of patients with open pelvic fractures after osteosynthesis are limited, and whether open fracture is a risk factor for worse outcomes, as compared with closed fracture, remains unclear. This study aimed to compare the functional outcomes of patients with open and closed pelvic fractures and evaluate potential factors that might affect outcomes. Patients’ demographic profile, associated injuries, management protocol, quality of reduction, and outcomes were recorded and analyzed
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