Intentional Fallers with Complex Pelvic and Acetabular Fractures Do Not have Worse Radiological and Functional Outcomes than Accidental Fallers
Abstract Background: Individuals who fell from heights of >6 m accidentally or intentionally can suffer from complex pelvic and acetabular fractures. The extent to which an intentional fall correlates with prognosis and outcome after osteosynthesis is unclear. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods: Between 2014 and 2017, individuals who fell from heights of >6 m, developed pelvic and acetabular fractures, survived after resuscitation, and completed surgical treatments were enrolled. The fallers were divided into the intentional and accidental fallers, and their clinical parameters were statistically evaluated and compared.Results: Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidentally. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. The group with intentional fallers had female sex predominance, higher injury and new injury severity scores, and longer hospital stay. However, the early loss of fixation (less than three month) and functional outcomes (6- and 12-month follow-up) did not significantly differ between the intentional and accidental fallers. Conclusions: The intentional fallers with pelvic and acetabular fractures might be accompanied by more severe injuries compared to accidental fallers. However, the radiological and functional outcomes of the intentional fallers after osteosynthesis were not inferior to those of the accidental fallers.