Patients reported poor health 10 years after displaced sacral fractures

Researchers noted that pain management can likely improve the quality of life in these patients.

Patients with surgically treated displaced sacral fractures reported poor health 10 years after their injury and showed no improvement from one-year follow-up according to data that were presented recently.

“Displaced sacral fractures are most often associated with significant morbidity,” Aron Adelved, MD, of the Orthopaedic Department at Akershus University Hospital, in Lørenskog, Norway, said. “There are several reports on poor medium- and long-term functional outcomes among these patients. However, there is little information about self-reported health among these patients in the long term. The objective of our study was to assess long-term patient-reported health after surgically treated displaced sacral fractures in a 10-year follow-up.”

Long-term study

Adelved and colleagues evaluated data from 28 patients enrolled in their study from 1996 to 2001 at Oslo University Hospital in Norway. All patients had displaced unstable sacral fractures; 22 patients underwent open reduction and internal fixation and six underwent closed reduction and screw fixation. Tötterman and colleagues previously reported one-year outcome data on these patients and found that the majority of patients achieved independent living but still had significant residual disability, including polytrauma.

In the current study, researchers followed the patients for a mean of 10.7 years postinjury. They collected data on patient-reported health with the Short Form-36 (SF-36), pain with a VAS, neurologic deficits in the lower extremities and urinary, bowel and sexual dysfunction.

At 10-year follow-up, “patients had significantly lower SF-36 scores compared with the age- and gender-adjusted scores for the Norwegian population,” Adelved said. “We compared these 10-year scores with the 1-year scores but could not find any significant changes over time in any of the SF-36 domains.”

Eight patients reported no pain at 10-year follow-up; of the remaining 20 patients, half reported lumbosacral pain and the other half reported lumbosacral pain in addition to radicular pain in the legs.

Pain correlated with function

The researchers found a significant correlation between pain and five of the eight SF-36 domains, including physical functioning, role physical, bodily pain, general health and role emotional.

“We also found that sexual dysfunction correlated with social functioning and role emotional, and bowel dysfunction correlated with bodily pain and role emotional,” Adelved said.

However, Adelved and colleagues found no correlations between SF-36 scores and urinary dysfunction or neurologic deficits in the lower extremities.

“We found some significant correlations between SF-36 and some clinical parameters, with pain showing the most significant association, suggesting that special attention should be paid to pain treatments in order to improve quality of life for these patients,” Adelved said in his presentation. – by Tina DiMarcantonio

References:

Adelved A. Paper #35. Presented at: Orthopaedic Trauma Association Annual Meeting. Oct. 9-12, 2013; Phoenix.
Tötterman A. 2007. Spine 32:1437-1443.

For more information:

Aron Adelved, MD, can be reached at the Orthopaedic Department, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway; email: aron.adelved@medisin.uio.no.
Disclosure: Adelved has no relevant financial disclosures.