title: Impact of isolated acetabular and lower extremity fractures on long-term outcome.
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
authors.affiliation: Department of Orthopaedic Trauma, University of Aachen Medical Center, Pauwelstrasse 30, Aachen, Germany. rpfeifer@ukaachen.de
authors.forename: Roman
authors.initials: R
authors.lastname: Pfeifer
authors.forename: Boris A
authors.initials: BA
authors.lastname: Zelle
authors.forename: Philipp
authors.initials: P
authors.lastname: Kobbe
authors.forename: Matthias
authors.initials: M
authors.lastname: Knobe
authors.forename: Robert L
authors.initials: RL
authors.lastname: Garrison
authors.forename: Simon
authors.initials: S
authors.lastname: Ohm
authors.forename: Nicola-Alexander
authors.initials: NA
authors.lastname: Sittaro
authors.forename: Christian
authors.initials: C
authors.lastname: Probst
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape
mesh_terms: D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000628:therapy*; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000628:therapy*; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D010147:Pain Measurement; D010808:Physical Examination; D011446:Prospective Studies; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D013978:Tibial Fractures / Q000628:therapy*; D016896:Treatment Outcome