title: Patient-reported health minimum 8 years after operatively treated displaced sacral fractures: a prospective cohort study.
abstract: OBJECTIVE
  To assess long-term patient-reported health (PRH) after displaced sacral fractures, its association with clinical outcomes, and changes over time.
  
  
  METHODS
  Prospective, longitudinal single-cohort study.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  From 1996 to 2001, 31 consecutive patients with operatively treated displaced sacral fractures participated in a 1-year follow-up. Twenty-eight of them were available for the present long-term follow-up of mean 10.7 years (range, 8.1-13.4) postinjury.
  
  
  METHODS
  Surgical treatment with open or closed reduction and internal fixation.
  
  
  METHODS
  PRH was the main outcome, determined by the Short Form-36 (SF-36). Data were also collected on pain (using a visual analog scale), bladder function, neurologic deficits in the lower extremities, bowel function, sexual function, activities of daily living, and employment status. SF-36 scores from the present study were compared with norm-based scores for the Norwegian general population and 1-year scores.
  
  
  RESULTS
  At the present follow-up, mean 10.7 years (range, 8.1-13.4) postinjury, SF-36 scores were significantly lower than norm-based scores for all domains except mental health. No significant changes were observed between 1-year scores and scores from the present study. Pain correlated significantly with poor scores in the domains physical functioning (P = 0.05), role physical (P = 0.01), bodily pain (P = 0.003), general health (P = 0.007), and role emotional (P = 0.006). Sexual dysfunction correlated with poor social functioning (P = 0.013) and poor role emotional (P = 0.04); and bowel dysfunction with bodily pain (P = 0.02) and poor role emotional (P = 0.03). No correlations were found between SF-36 scores and bladder dysfunction or neurologic deficits.
  
  
  CONCLUSIONS
  Patients with displaced sacral fractures reported poor PRH, mean 10.7 years after the initial injury, with no significant improvement compared with 1-year follow-up. A significant association was found between pain and PRH.
  
  
  METHODS
  Therapeutic level IV. description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, Oslo University Hospital, Ullevaal, Oslo, Norway; †Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway; ‡Department of Orthopaedic Surgery, Karolinska University Hospital, Stockholm, Sweden; §Department of Spinal Cord Injury and Multitrauma Unit, Sunnaas Hospital, Nesodden, Norway; ‖Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevaal, Oslo, Norway; ¶Faculty of Medicine, University of Oslo, Oslo, Norway; and **Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
authors.forename: Aron
authors.initials: A
authors.lastname: Adelved
authors.forename: Anna
authors.initials: A
authors.lastname: Tötterman
authors.forename: Thomas
authors.initials: T
authors.lastname: Glott
authors.forename: Helene L
authors.initials: HL
authors.lastname: Søberg
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Madsen
authors.forename: Olav
authors.initials: O
authors.lastname: Røise
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D020127:Recovery of Function; D012447:Sacrum / Q000293:injuries / Q000601:surgery*; D057566:Self Report; D016896:Treatment Outcome