Pelvic Ring Injuries and Acetabular Fractures : Quality of Life Following Surgical Treatment

Sammanfattning: The overall aim was to study outcome following surgery of the injured pelvis with focus on assessment from the patient’s perspective. All adult patients operatively treated for pelvic ring injuries or acetabular fractures at the Department of Orthopaedics, Uppsala University, starting 2003 were prospectively included and followed with quality of life (QoL) instruments for 2 years. The most common trauma mechanism was motor vehicle accident (MVA). Study I included 54 patients with pelvic ring injuries during the three-year period 2003-2005. The two instruments, SF-36 and LiSat-11, were used. In 45 responders lower than normative QoL and life satisfaction prevailed at two years after the injury. Study II included 12 patients with pelvic ring injuries or acetabular fractures sustained following a jump from height in an attempt to commit suicide. At four years all patients were still alive and SCID-interviews performed by a psychiatrist revealed low recurrence of self-destructive behaviour and high QoL in the younger patients. Study III included 136 patients with acetabular fractures where 52 had elementary and 84 associated fracture patterns. Fracture reduction was 0-1 mm in 106 patients and 2 mm or more in 30. QoL was significantly higher in patients with anatomically reduced fractures. Physical SF-36 domains improved with time, albeit QoL was lower than norm. Study IV had the aim to construct a condition-specific outcome instrument for patients with acetabular fractures. Closed and open questions were sent to 127 consecutive acetabular fracture patients at 6, 12 and 24 months following surgery. Responses were validated through factor analysis, scree tests, item reduction and principal component analysis which resulted in a multi-item verbal descriptive scale (VDS) with six condition-specific questions related to “Pain”, “Walking”, “Hip motion”, “Leg numbness”, “Sexual life”, “Operation scar” and a global question concerning impact on daily life activities for acetabular fracture assessment.