MEDIUM-LONG TERM OUTCOME OF OPERATIVELY TREATED UNSTABLE SACRAL FRACTURES

Aim. Primary aim of this study is the evaluation of the medium-long term outcome of sacral fractures on the basis of the patient and injury characteristics and the quality of the reduction. Secondary objective is the validation of a new grading instrument for the outcome of pelvic ring disruptions. Methods. This retrospective study includes 44 patients with unstable sacral fracture surgically treated from 2002 to 2009 at AO C.T.O./Maria Adelaide, Turin and University Hospital S. Luigi Gonzaga, Orbassano, with mean age 38.72 years (range 18-63). The functional evaluation was achieved by both the Majeed score and a more complete questionnaire (Integrated Score) which could investigate the different dysfunctions. The mean follow-up was 23 months (range 7-54). Results. Global quality of life resulted reduced in the majority of patients: urologic dysfunction were the less represented, while sexual function was the most affected, with some differences between males and females. Preoperative displacement, sacral canal involvement and the quality of the reduction showed a strong prognostic meaning. The Integrated Score demonstrated excellent correlation with the Majeed score: it could be so proposed as a valid instrument for the grading of pelvic fractures outcome. Conclusion. The prognosis of sacral fractures is afflicted by a wide spectrum of relevant dysfunctions. The comprehension of long-term outcome of pelvic ring disruptions could have important prognostic and therapeutic implications, in order to warrant to these patients a better quality of life.