Do asymptomatic patients have normal function after percutaneous fixation of the posterior pelvic ring? A case-control p
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RESEARCH ARTICLE
Open Access
Do asymptomatic patients have normal function after percutaneous fixation of the posterior pelvic ring? A case-control pilot study Pooria Salari, Lisa K Cannada and Berton R Moed*
Abstract Background: Following treatment of a posterior pelvic disruption, residual deformity or associated injuries can adversely affect functional recovery. No study has been performed on gait and functional outcome after closed reduction and percutaneous screw fixation (CRPSF) of posterior pelvic disruption in clinically asymptomatic patients. The purpose of this study was to determine if gait and functional outcome are different from normal in asymptomatic patients with a posterior pelvic injury after CRPSF, serving as a pilot study in this regard. Methods: Six asymptomatic patients with no grossly evident gait abnormality, treated by CRPSF for a posterior pelvic disruption, were included in the study (SG). A control group (CG) of six healthy volunteers was created. All participants completed the 12-Item Short Form Health Survey version 2 (SF-12v2), the Majeed Pelvic Score (MPS), and the Iowa Pelvic Score (IPS). In addition, the participants’ gait was analyzed. Results: Pelvic drop was significantly smaller on the uninjured side in the SG when compared to the injured side in the SG. There was no significant difference between the injured and uninjured side for other gait parameters within the SG. Knee angle at initial contact was significantly greater on the injured side when compared to the CG. The SG scored statistically worse than the CG on the Physical Component Summary part of the SF-12v2. However, when evaluated by age group using national mean scores, the SG differences were minimal. All six patients in our study scored “excellent” on both MPS and IPS. Conclusions: Despite having subclinical alterations in gait, asymptomatic pelvic ring injured patients show minimal, if any, evidence of impaired functional outcome following successful reduction of a posterior pelvic disruption treated by CRPSF. Keywords: Pelvic fracture outcome, Percutaneous iliosacral screws, Type C pelvic ring injuries
Background Pelvic fractures account for 1%–3% of all skeletal fractures and 2% of orthopedic hospital admissions [1,2]. These fractures comprise a broad spectrum of injuries, from low-energy slip-and-fall fractures in osteoporotic patients to high-energy disruptions caused by motor vehicle accidents. Following treatment of these pelvic injuries, residual deformity or associated injuries are felt to adversely affect functional recovery [3-9]. Type C injuries to the posterior aspect of the pelvic ring with sacroiliac joint dislocation or fracture/dislocation and displaced sa* Correspondence: [email protected] Department of Orthopaedic Surgery, Saint Louis University School of Medicine, 3635 Vista Avenue, 7th Floor Desloge Towers, St. Louis, MO 63110, USA
cral fracture are associated with higher morbidity and mortality [6,10,11]. Conventional wisdom is that in general these patients do not do well. Long-term medical
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