TY - JOUR
T1 - Impact of isolated acetabular and lower extremity fractures on long-term outcome
AU - Pfeifer, Roman
AU - Zelle, Boris A.
AU - Kobbe, Philipp
AU - Knobe, Matthias
AU - Garrison, Robert L.
AU - Ohm, Simon
AU - Sittaro, Nicola Alexander
AU - Probst, Christian
AU - Pape, Hans Christoph
PY - 2012/2
Y1 - 2012/2
N2 - BACKGROUND: The long-term clinical status of surviving patients with multiple injuries has not been well described. The aim of this study was to evaluate the long-term outcome of acetabular and lower limb injuries. METHODS: Patients treated at a Level I trauma center at least 10 years before participation in this study were invited for a follow-up physical examination. Six hundred thirty-seven patients were examined. Inclusion criteria are as follows: Injury Severity Score ≥16 Points; treatment in a Level I trauma center; and injuries of the lower limb: fractures of the acetabulum, proximal femur, femoral shaft, knee joint, and tibial shaft. Exclusion criteria are as follows: incomplete follow-up examination, amputations, ankle and foot fractures, and patients older than 60 years and younger than 3 years. The follow-up examination included the following parameters: range of motion, pain, limping, successful rehabilitation, and outcome scores. RESULTS: Of 525 patients with fractures of the acetabulum and lower limb, 229 patients fulfilled the inclusion criteria. Mean age: 24.9 (range, 3-60) years; Injury Severity Score: 19.66 (range, 16-43). The most frequent rates of ongoing local pain were stated by patients with fractures of the acetabulum (50%) and the proximal femur (45%). Moreover, the incidence of abnormal gait was significantly lower in patients with femoral shaft fractures when compared with the patients with fractures of the acetabulum (3.7% vs. 35%; p ≤ 0.0001), proximal femur (3.7% vs. 20%; p = 0.006), and tibial shaft (3.7% vs. 14.7%; p = 0.023). CONCLUSIONS: Our results demonstrate a better long-term outcome in patients with femur shaft fractures, whereas patients with articular fractures and proximal femur fractures were associated with poorer outcomes. Fracture location is determining factor for long-term outcome.
AB - BACKGROUND: The long-term clinical status of surviving patients with multiple injuries has not been well described. The aim of this study was to evaluate the long-term outcome of acetabular and lower limb injuries. METHODS: Patients treated at a Level I trauma center at least 10 years before participation in this study were invited for a follow-up physical examination. Six hundred thirty-seven patients were examined. Inclusion criteria are as follows: Injury Severity Score ≥16 Points; treatment in a Level I trauma center; and injuries of the lower limb: fractures of the acetabulum, proximal femur, femoral shaft, knee joint, and tibial shaft. Exclusion criteria are as follows: incomplete follow-up examination, amputations, ankle and foot fractures, and patients older than 60 years and younger than 3 years. The follow-up examination included the following parameters: range of motion, pain, limping, successful rehabilitation, and outcome scores. RESULTS: Of 525 patients with fractures of the acetabulum and lower limb, 229 patients fulfilled the inclusion criteria. Mean age: 24.9 (range, 3-60) years; Injury Severity Score: 19.66 (range, 16-43). The most frequent rates of ongoing local pain were stated by patients with fractures of the acetabulum (50%) and the proximal femur (45%). Moreover, the incidence of abnormal gait was significantly lower in patients with femoral shaft fractures when compared with the patients with fractures of the acetabulum (3.7% vs. 35%; p ≤ 0.0001), proximal femur (3.7% vs. 20%; p = 0.006), and tibial shaft (3.7% vs. 14.7%; p = 0.023). CONCLUSIONS: Our results demonstrate a better long-term outcome in patients with femur shaft fractures, whereas patients with articular fractures and proximal femur fractures were associated with poorer outcomes. Fracture location is determining factor for long-term outcome.
KW - Acetabulum
KW - Long-term outcome
KW - Lower extremity
KW - Multiple injuries
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U2 - 10.1097/TA.0b013e318219fbfa
DO - 10.1097/TA.0b013e318219fbfa
M3 - Article
C2 - 22439211
AN - SCOPUS:84860566075
SN - 2163-0755
VL - 72
SP - 467
EP - 472
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 2
ER -