Is patient-reported outcome after treatment of pelvic ring injuries related to pelvic symmetry? A prospective study

Abstract Purpose. To analyze the relation between pelvic symmetry, as measured by the cross-measurement technique, and patient-reported outcome measures (PROMs) in terms of functional status and health-related quality of life. Methods. In this prospective cohort study, X and Y measurements were taken according to the cross- measurement technique on AP radiographs of patients who were treated for a pelvic ring injury in a level 1 trauma center. Patients completed PROMs one year following their injury, reporting their functional status with the Short Musculoskeletal Function Assessment (SMFA-NL), specifically lower extremity dysfunction (LED), problems with daily activities (PDA) and mental and emotional problems (MEP) subscales, and quality of life with EuroQol-5D (EQ-5D). Subgroup analyses were also performed. PROMs were used to analyze the relation between pelvic symmetry and patient-reported outcome, using Spearman’s Rank correlation coefficients. Results. A total of 113 patients (mean age 57 (SD 17.7) years) with pelvic ring injury were included, of which 27 (24%) sustained type A injuries, 64 (57%) type B and 22 (20%) type C injuries. Forty-four (39%) patients were treated operatively. The median pelvic symmetry ratio was 1.01 (IQR 0.07). Weak or no correlations were found between the pelvic symmetry scores and the outcome measurements (Spearman’s correlation coefficients: LED r=0.06; PDA r=0.11; MEP r=-0.02; and EQ-5D r=-0.09). Subgroup analyses revealed no correlations. Conclusions. Pelvic symmetry is not related to functional status and health-related quality of life, one year after pelvic ring injury. This indicates that some degree of pelvic asymmetry may be well tolerated by patients.