Impact of isolated acetabular and lower extremity fractures on long-term outcome

Roman Pfeifer, Boris A. Zelle, Philipp Kobbe, Matthias Knobe, Robert L. Garrison, Simon Ohm, Nicola Alexander Sittaro, Christian Probst, Hans Christoph Pape

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)467-472
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume72
Issue number2
DOIs
StatePublished - Feb 1 2012
Externally publishedYes

Keywords

  • Acetabulum
  • Long-term outcome
  • Lower extremity
  • Multiple injuries

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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