Majeed (1989) proposes a numerical scoring system for functional recovery after major pelvic fractures. Developed from a 5-year prospective study of 60 surgically treated patients, it scores five domains for a total out of 100 (or 80 for non-working patients). The system was created because radiographic grading consistently failed to reflect actual functional outcomes.
X-rays lie after pelvic fractures. Majeed showed that anatomically 'poor' reductions routinely produced excellent patient function — which is why functional scoring, not radiographic grading, is now the standard for reporting pelvic fracture outcomes.
When you assess a pelvic fracture patient in clinic, run through the five Majeed domains: pain, standing (aids, gait, distance), sitting, sexual function, and work. The score tells you where the patient is failing and gives you a reproducible number to track over time.
For non-working patients (elderly, retired), score out of 80 and apply the lower grade thresholds. A score of 72 is Excellent for a retired patient but only Good for a working one. Using the wrong denominator will systematically misgrade outcomes.
If acetabular involvement is major, the Majeed score is insufficient on its own. Supplement with a dedicated hip outcome measure. The authors specifically recommend Merle d'Aubigné and Postel.
Majeed (1989) proposes a numerical scoring system for functional recovery after major pelvic fractures. Developed from a 5-year prospective study of 60 surgically treated patients, it scores five domains for a total out of 100 (or 80 for non-working patients). The system was created because radiographic grading consistently failed to reflect actual functional outcomes.
X-rays lie after pelvic fractures. Majeed showed that anatomically 'poor' reductions routinely produced excellent patient function — which is why functional scoring, not radiographic grading, is now the standard for reporting pelvic fracture outcomes.
When you assess a pelvic fracture patient in clinic, run through the five Majeed domains: pain, standing (aids, gait, distance), sitting, sexual function, and work. The score tells you where the patient is failing and gives you a reproducible number to track over time.
For non-working patients (elderly, retired), score out of 80 and apply the lower grade thresholds. A score of 72 is Excellent for a retired patient but only Good for a working one. Using the wrong denominator will systematically misgrade outcomes.
If acetabular involvement is major, the Majeed score is insufficient on its own. Supplement with a dedicated hip outcome measure. The authors specifically recommend Merle d'Aubigné and Postel.