title: Persistent impairment after surgically treated lateral compression pelvic injury.
abstract: BACKGROUND
  Recently, fixation of lateral compression (LC) pelvic fractures has been advocated to improve patient comfort and to allow earlier mobilization without loss of reduction, thus minimizing adverse systemic effects. However, the degree of acceptable deformity and persistence of disability are unclear.
  
  
  OBJECTIVE
  We determined if (1) injury pattern; (2) demographics; (3) final posterior displacement; (4) L5/S1 involvement; (5) associated injuries; and (6) time influence outcome measurements, sexual dysfunction, and pain.
  
  
  METHODS
  We retrospectively reviewed 119 patients with unstable LC injuries treated surgically between 2000 and 2010. There were 52 males and 67 females; mean age was 39 years with a mean body mass index of 27 kg/m(2). All patients underwent clinical examination and radiographic imaging for instability and accompanying injuries. We obtained Short Musculoskeletal Function Assessment (SMFA). The minimum followup was 12 months (mean, 33 months; range, 12-100 months).
  
  
  RESULTS
  SMFA subscores were not affected by injury pattern and demographics. Posterior reduction was less than 5 mm with persistent displacement in 99 of 119 (83%). Displacement of 5 to 10 mm did not affect any SMFA subscore at any time interval. Patients with additional lower extremity injuries had worse SMFA scores. Function improved with time. A visual analog scale pain score of 4 or more at 6 months predicted pain and overall SMFA score at last followup.
  
  
  CONCLUSIONS
  Unstable LC pelvic ring injuries result in persistent disability based on validated outcome measurements. Near anatomical reduction can be achieved and maintained. While our findings need to be confirmed in studies with high rates of followup, patients with unstable LC pelvic injuries should be counseled concerning the possibility of some degree of persistent disability.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Grand Rapids Medical Educational Partners, Grand Rapids, MI, USA.
authors.forename: Martin F
authors.initials: MF
authors.lastname: Hoffmann
authors.forename: Clifford B
authors.initials: CB
authors.lastname: Jones
authors.forename: Debra L
authors.initials: DL
authors.lastname: Sietsema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006305:Health Status Indicators; D006620:Hip Fractures / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010384:Pelvic Bones / Q000293:injuries*; D011183:Postoperative Complications; D011788:Quality of Life; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult