Patient-reported outcome following an acetabular fracture: an observational study of 385 patients from the Swedish Fracture Register.

Background and purpose:  The primary aim of this study was to assess the patient's self-reported change in health 1 year after sustaining an acetabular fracture. The secondary objective was to examine differences in patient-reported outcomes (PROMs) based on sex, age groups, injury mechanisms, type of fracture, and treatment.

Methods:  Data was collected from the Swedish Fracture Register (SFR) for patients with acetabular fractures sustained between 2014 and 2021. Patients with additional fractures at the time of injury or during the following 18 months, periprosthetic fractures, or pediatric fractures were excluded. The PROM used was the Short Musculoskeletal Function Assessment (SMFA) wherein the subindices of bother, dysfunction, and mobility were analyzed with a higher score indicating worse outcome. The differences in SMFA and in subindices between the score 1 year after fracture and preinjury (recall) were analyzed.

Results:  Of the 385 included patients with complete PROMs, there was no significant difference in changes in SMFA score between the sexes. Surgically treated patients had significantly higher scores 1 year post-injury compared with non-surgically treated patients with bother index 18.3 (95% confidence [CI] 14.0-22.6) vs 7.2 (CI 4.7-9.8), dysfunction index 15.8 (CI 12.7-18.9) vs 7.0 (CI 5.0-9.0), and mobility index 21.6 (CI 17.9-25.2) vs 9.2 (CI 6.9-11.5).

Conclusion:  Most patients sustaining an acetabular fracture experience a decline in their functional abilities 1 year after the injury compared with before the injury. Younger patients with high-energy injuries and complex fracture types, which typically require surgical intervention, experience the most unfavorable outcomes. The large group of non-surgically treated patients reported minimal functional changes, likely attributable to selection bias.