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01.12.2014 | Original Article | Ausgabe 8/2014

European Journal of Orthopaedic Surgery & Traumatology 8/2014

Elderly pelvic fractures: the incidence is increasing and patient demographics can be used to predict the outcome

Zeitschrift:
European Journal of Orthopaedic Surgery & Traumatology > Ausgabe 8/2014
Autoren:
Nicholas D. Clement, Charles M. Court-Brown

Abstract

Objectives

To (1) to determine the incidence of elderly pelvic fractures over the last decade, (2) describe the epidemiology and outcome of patients with pubic rami fractures and compare these to those patients sustaining all other pelvic fractures, and (3) identify independent predictors of length of stay, return to domicile, and 1-year mortality for patients with pubic rami fractures.

Methods

We retrospectively identified 937 elderly patients (≥65 years) with pelvic fractures presenting to the study centre over a 15-year period. Patient demographics, mechanism of injury, and associated fractures were recorded for a defined 2-year period. Outcomes assessed were length of stay, return to original place of domicile, and 1-year mortality.

Results

The incidence increased from 7.9 per 100,000 to 13.1 per 100,000. The majority were fragility fractures of the pubic rami (84 %). Patients sustaining a pubic rami fracture were older, more likely to be female, less deprived and have sustained an isolated injury by a low-energy mechanism. Patients sustaining a pubic rami fracture were less likely to return to their original place of domicile. Pre-injury independence and mobility, socioeconomic status, associated fractures, energy of injury, and male gender were independent predictors of length of stay, return to original place of domicile, and 1-year mortality.

Conclusion

The incidence of elderly pelvic fractures is increasing, and fractures of the pubic ramus have different patient demographics compared to other pelvic fractures. Patient demographics could be used to predict: length of stay, return to domicile, and 1-year mortality after a pubic rami fracture.

Level of evidence

Retrospective prognostic study, Level IV.

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