Quality of reduction correlates with clinical outcome in pelvic ring fractures

INTRODUCTION Posttraumatic pelvic deformity is associated with pain and loss of function. This study aimed to test the correlation of functional outcome in patients with pelvic fractures with the postoperative radiographic quality of reduction. METHODS Consecutive patients with an isolated traumatic pelvic fracture that required closed or open reduction between 07/2015 and 07/2017 and had a completed follow-up of at least 6 months were included (N = 31, mean age 50 years, SD 21 years, range, 16 to 88 years). Majeed and Timed Up & Go were obtained from a prospective outcome database at 6 months and last follow-up (mean 10 months, SD 5 months). Quality of pelvic ring reduction was determined on postoperative radiographs as described by Matta, Sagi and Keshishyan/Lefaivre. RESULTS Clinical outcome at 6 months as measured by the Majeed and the Timed Up & Go correlated moderately with Keshishyan/Lefaivre's pelvic asymmetry value (Pearson R: -0.520 and 0.585, p ≤ 0.003) and the pelvic deformity index (-0.527 and 0.503, p ≤ 0.004). There was a weak correlation between the Timed Up & Go and the radiographic grading system as described by Matta/Tournetta at 6 months (0.408, p = 0.023) and at last follow-up (0.380, p = 0.035). CONCLUSIONS This study showed a moderate correlation of the clinical outcome at 6 months with postoperative quality of radiographic reduction when measured with the method described by Keshishyan and Lefaivre. Although having only descriptive value due to the small cohort, our findings underline the importance of anatomic reduction and restoration of pelvic symmetry in patients with pelvic trauma. Future studies with more patients and more investigators are required and reliability and validity of functional outcome scores needs to be further assessed to predict outcome in patient with fractures of the pelvic ring. LEVEL OF EVIDENCE Level IV (case series)