Prospective Characterization of Pain and Function in Patients With Unstable Pelvic Fractures Treated With Posterior Screw Fixation. Issue 11 (November 2022)

• Record Type: Journal Article
• Authors: O'Hara, Nathan N.; Sim, Danielle; Moore, Darby; Campbell, Peter; Allen, Vincent; Nascone, Marco; Hasan, Sania; Stockton, David J.; Demyanovich, Haley; Sciadini, Marcus F.; O'Toole, Robert V.; Slobogean, Gerard P.
• Is Part Of: Journal of orthopaedic trauma. Volume 36:Issue 11(2022)
• Page Start: 557
• Page End: 563
• Publication Date: 2022-11
• Subjects: patient-reported pain -- patient-reported function -- pelvic fracture -- posterior screw fixation -- sacroiliac -- transiliac screws; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002416
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract : Objectives: Describe patient-reported pain and function within 24 months of a pelvic fracture treated with posterior screw fixation and identify factors associated with increased pain. Design: Prospective case series. Setting: Academic trauma center. Patients/Intervention: Eighty-eight patients with adult pelvic fracture treated with sacroiliac or transiliac screws. Main Outcome Measures: Average pain measured with the Brief Pain Inventory (BPI); function measured with the Majeed Pelvic Outcome Score from 6 to 24 months postinjury. Results: The mean pain from 6 to 24 months postinjury was 2.22 on the 10-point BPI scale (95% CI, 0.64–3.81). Sixty-nine patients (78.4%) reported mild to no pain at 6 months; 12 (13.6%) patients had severe pain. Two years after injury, 71 patients (80.6%) exhibited mild to no pain. Within 24 months of injury, the mean pelvic function was 71 on the 100-point Majeed scale (95% CI, 60–82). Half of the sample (n = 44) had good to excellent pelvis function by 6 months postinjury; 55 patients (62.5%) attained this level of function by 24 months. A history of chronic pain (1.31; 95% CI, 0.26–2.37; P = 0.02), initial fracture displacement (≥5 mm) (0.99; 95% CI, 0.23–1.69; P = 0.01), and socioeconomic deprivation (0.28; 95% CI, 0.11–0.44; P < 0.01) were significantly associated with increased pain. Conclusion: Our findings suggest that most patients with unstable pelvic ring fractures treated with posterior screw fixation achieve minimal to no pelvis pain and good to excellent pelvic function 6–24 months after injury. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.