gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018)

23.10. - 26.10.2018, Berlin

Impact of multiple lower limb injuries on long-term pain outcome

Meeting Abstract

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  • presenting/speaker Thomas Rauer - UniversitätsSpital Zürich, Klinik für Traumatologie, Zürich, Switzerland
  • Roman Pfeifer - UniversitätsSpital Zürich, Klinik für Traumatologie, Zürich, Switzerland
  • Hans-Christoph Pape - UniversitätsSpital Zürich, Klinik für Traumatologie, Zürich, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018). Berlin, 23.-26.10.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocAT16-1361

doi: 10.3205/18dkou320, urn:nbn:de:0183-18dkou3203

Veröffentlicht: 6. November 2018

© 2018 Rauer et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: The long-term outcome of surviving patients with multiple injuries with respect to chronic pain has not been well described. The aim of this study was to evaluate the long-term outcome of patients with multiple lower limb injuries with respect to chronic pain.

Methods: Patients treated at a Level I trauma center at least 10 years before participation in this study were invited for a follow-up physical examination. Six hundred thirty-seven patients were examined. Chronic pain was identified based on a patient questionnaire.

Inclusion criteria are as follows: Injury Severity Score 16 Points; treatment in a Level I trauma center; injuries of the lower leg including fractures of the acetabulum, proximal femur, femoral shaft, knee joint, proximal lower leg, lower leg shaft, distal lower leg and foot.

Exclusion criteria are as follows: incomplete follow-up examination, amputations, patients older than 60 and younger than 3 years.

Results and conclusion: Of 525 patients with multiple lower limb injuries, we identified patients complaining about posttraumatic chronic pain. Mean age: 24.9 (range, 3-60) years; Injury Severity Score: 19.66 (range, 16-43).

Patients with combined proximal femur and proximal tibia fractures (13%) or proximal tibia and tibial shaft fractures (13%) stated the most frequent rates of ongoing pain.

Patients with combined femoral shaft and distal tibia fractures (13%) or femoral shaft and tibial shaft fractures (13%) stated the most frequent rates of pain that occur during physical exercise.

In contrast, patients with combined femoral shaft and proximal tibia fractures (18%) reported only about rarely occurring pain.

Our results demonstrate a better long-term outcome in patients with combined femoral shaft and proximal tibia fractures, whereas patients with the combination of two articular fractures or two shaft fractures of the lower limb or patients with a complex segmental tibia fractures were associated with poorer outcomes. Therefore, not only isolated fractures but also the combination of fractures and their location are determining factors for the long-term outcome in polytraumatised patients.