Pelvic ring fractures in the elderly now and then – a pelvic registry study

Pelvic ring fractures are rare injuries in the elderly though the incidence is increasing due to the increasing age of the population. Main goal of treatment is the quickest possible re-mobilization to prevent side-effects of immobilization such as osteopenia, pulmonary infections or thromboembolic events. Isolated anterior pelvic ring fractures are stable injuries and therefore they usually can be treated conservatively, while pelvic ring injuries with involvement of the posterior ring are considered unstable and should undergo surgical stabilization if the patient’s condition allows for it. Conservative treatment includes adequate analgesia, guided mobilization with partial weight bearing if possible and osteoanabolic medication. The appropriate surgical procedure should be discussed in an interdisciplinary round considering patient’s pre-injury condition, anaesthetic and surgical risks. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180062

Download Full-text

In-hospital mortality of pelvic ring fractures in older adults now and then: A pelvic registry study

Geriatrics and Gerontology International ◽

10.1111/ggi.13558 ◽

2018 ◽

Vol 19 (1) ◽

pp. 24-29 ◽

Cited By ~ 2

Author(s):

Mika F Rollmann ◽

Steven C Herath ◽

Benedikt J Braun ◽

Joerg H Holstein ◽

Tim Pohlemann ◽

...

Keyword(s):

Older Adults ◽

Hospital Mortality ◽

Pelvic Ring ◽

Registry Study ◽

Pelvic Ring Fractures

Download Full-text

J.W.R. Young and A.R. Burgess, Radiologic Management of Pelvic Ring Fractures, Systematic Radiographic Diagnosis, Urban & Schwarzenberg, Baltimore, Munich (1987) 94 pp., 82 figs.

Clinical Radiology ◽

10.1016/s0009-9260(88)80383-0 ◽

1988 ◽

Vol 39 (2) ◽

pp. 256-256

Author(s):

P RENTON

Keyword(s):

Pelvic Ring ◽

Radiographic Diagnosis ◽

Pelvic Ring Fractures

Download Full-text

Insufficiency Fractures vs. Low-Energy Pelvic Ring Fractures – Epidemiological, Diagnostic and Therapeutic Characteristics of Fragility Fractures of the Pelvic Ring

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1394-6502 ◽

2021 ◽

Author(s):

Manuel Sterneder ◽

Patricia Lang ◽

Hans-Joachim Riesner ◽

Carsten Hackenbroch ◽

Benedikt Friemert ◽

...

Keyword(s):

Pelvic Ring ◽

Diagnostic Testing ◽

Insufficiency Fracture ◽

Fragility Fractures ◽

Relative Increase ◽

Trauma Centre ◽

Low Energy ◽

Insufficiency Fractures ◽

Type Iv ◽

Pelvic Ring Fractures

Abstract Background Fragility fractures of the pelvis (FFP) encompass two fracture entities: fracture after low-energy trauma and insufficiency fracture without trauma. It is unclear whether the two subgroups differ in terms of diagnosis and therapy. The aim of this retrospective study was to evaluate insufficiency fractures with regard to defined parameters and to compare specific parameters with the fractures after low-energy trauma. Patients and Methods In the period from 2008 to 2017, 203 patients with FFP were recorded at our clinic (Level 1 Trauma Centre DGU, SAV approval). Of these, 25 had an insufficiency fracture and 178 had a pelvic ring fracture after low-energy trauma. Epidemiological, diagnostic and therapeutic parameters were examined. Results There was a relative increase in the insufficiency fracture within the FFP (2008 – 2009: 5.0% vs. 2015 – 2017: 17.8%). In these patients, osteoporosis tended to be more pronounced than in patients after low-energy trauma (t-value: − 3.66 vs. − 3.13). The diagnosis of insufficiency fractures showed increased use of MRI and DECT (60.9% vs. 26.0%) and a high proportion of type IV fractures after FFP (40.0% vs. 7.9%). In terms of therapy, surgical treatment of the insufficiency fracture was sought more often (68,2% vs. 52,1%), with a tendency towards increased use of combined osteosynthesis procedures (14.3% vs. 7.6%). Conclusion We were able to show that as the number of cases increases, the insufficiency fracture becomes more important within FFP. If these patients tend to have more pronounced osteoporosis, particular attention should be paid to the diagnosis and adequate therapy of the osteoporosis, especially in the case of an insufficiency fracture. In addition to the increased diagnostic testing using MRI and DECT to detect oedema and the increased surgical therapy for this type of fracture, it is also noteworthy that the insufficiency fracture can cause higher-grade fractures after FFP.

Download Full-text

Low-Energy Pelvic Ring Fractures: A Care Conundrum

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320985406 ◽

2021 ◽

Vol 12 ◽

pp. 215145932098540

Author(s):

Bailey R. Abernathy ◽

Lisa K. Schroder ◽

Deborah C. Bohn ◽

Julie A. Switzer

Keyword(s):

Acute Care ◽

Patient Population ◽

Pelvic Ring ◽

Fracture Prevention ◽

Low Energy ◽

Care Pathways ◽

Secondary Fracture ◽

Secondary Fracture Prevention ◽

Pelvic Ring Fractures ◽

Rehabilitative Care

Introduction: A need exists for improved care pathways for patients experiencing low-energy pelvic ring fractures. A review of the current literature was performed to understand the typical patient care and post-acute rehabilitation pathway within the US healthcare system. We also sought to summarize reported clinical outcomes worldwide. Significance: Low-energy pelvic ring fracture patients usually do not qualify for inpatient admission, yet they often require post-acute rehabilitative care. The Center for Medicare and Medicaid Services’ (CMS) 3-day rule is a barrier to obtaining financial coverage of this rehabilitative care. Results: Direct admission of some patients to post-acute care facilities has shown promise with decreased cost, improved patient outcomes, and increased patient satisfaction. Secondary fracture prevention programs may also improve outcomes for this patient population. Conclusions: Post-acute care innovation and secondary fracture prevention should be prioritized in the low-energy pelvic fragility fracture patient population. To demonstrate the effect and feasibility of these improved care pathways, further studies are necessary.

Download Full-text