Quality of life, sexual function, and gait disturbances after pelvic fractures: An ambispective cohort study at a level 1 trauma centre

Objectives: Pelvic fractures are associated with significant long-term complications, including pain, infertility, gait disturbances, and sexual dysfunction, which adversely affect quality of life (QoL). Existing literature, mostly from Western populations, often addresses a single outcome without a comprehensive evaluation, and data from the Indian population remains scarce. Hence, we conducted this study to evaluate the long-term impact of pelvic fractures on quality of life, sexual function, infertility, gait, gluteal claudication, and associated factors in an Indian population using validated tools. Methodology: An ambispective observational study was conducted at a Level 1 trauma center in North India, with retrospective data from 2014–2017 and prospective data from 2017-2018. Patients aged ≥18 years with pelvic fractures were included. Data collection involved hospital records, outpatient follow-ups, and telephone interviews. Tools used included the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) for Quality of Life (QOL, the Brief Male Sexual Function Inventory (BSFI) for male sexual function, the Female Sexual Function Index (FSFI) for female sexual function, and specific assessments for gait, pain, infertility, and gluteal claudication. Statistical analysis was performed using SPSS v23.0. Results: Out of 501 eligible patients, 133 (31.8%) were followed up. Limping was reported in 31.6% initially, reducing to 13% at 6 months. Pain was present in 27.8%. Among males, 36.6% reported premature/retrograde ejaculation; 16.1% had urogenital injuries. Infertility was noted in 28.6% of retrospective females, with one case associated with angioembolization. Mean WHOQOL-BREF scores showed significant improvement across all domains at 6 months, though psychological and environmental domains remained lower. Gluteal claudication was reported in 22.2% retrospectively and 11.6% prospectively at 6 months. BSFI and FSFI scores were lower post-injury but showed gradual improvement with time. Conclusion: Pelvic fractures have a profound impact on quality of life, sexual function, and mobility, with a subset of patients experiencing persistent issues. However, improvements are seen over time with appropriate follow-up and rehabilitation. This study underscores the need for comprehensive, multidisciplinary long-term care in pelvic trauma and highlights the utility of validated questionnaires for outcome assessment in the Indian context.