Short-Term Outcomes of Unstable Pelvic Fractures in Adults Treated at Mulago National Referral Hospital

Background Pelvic fractures are a significant health issue, with over 4.5 million new cases annually and high morbidity and mortality. Unstable pelvic fractures, affecting the posterior pelvic ring, pose severe hemorrhage risks and poor outcomes. Classification systems like Tile and Young-Burgess aid in management. Current treatment emphasizes early hemorrhage control and surgical stabilization for better recovery. Functional outcomes, measured with the Majeed score, depend on injury severity and care quality. Given the limited research on short-term outcomes in sub-Saharan Africa, this study aims to evaluate the short-term radiological and functional outcomes, as well as predictors of functional outcomes of unstable pelvic fractures in adults at Mulago National Referral Hospital. Methods A cross-sectional study was conducted on 51 patients who met the inclusion criteria. Functional outcomes were assessed using the Majeed Pelvic score, while Radiological outcomes were evaluated for bony union, non-union, and malunion. Data was collected using a structured questionnaire and analyzed using STATA version 15. Results The median age was 31 (IQR 25,38), and the male sex dominated 56.9% (n = 29). A satisfactory functional outcome was observed among 57% (n = 29) of the patients. Radiological union occurred among 78% (n = 40) of the patients. Significant predictors of unsatisfactory outcomes were primary (APR = 1.23, 95% CI: 1.03–1.46, p = 0.023), nerve damage (APR = 1.31, 95% CI: 1.09–1.59, p = 0.005), and fracture management (APR = 1.24, 95% CI: 1.05–1.46, p = 0.011). Conclusion Nearly half of patients with unstable pelvic fractures in Uganda experience unsatisfactory short-term functional outcomes, with low education, nerve injury, and non-operative management as key predictors. Early anteroposterior malalignment also significantly affects function, highlighting the need for patient education and timely, precise surgical care