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Fragility fractures of the pelvis: treatment and preliminary results

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Abstract

Background

With increasing life expectancy, fragility fractures of the pelvic ring (FFP) are becoming frequent. In elderly, osteoporosis leads to a decrease of bone strength and resistance to the ligament’s traction; this represents the most important difference between FFP and fractures in young patients. Usually, these fractures are underestimated and treatment is often conservative.

Aims

To evaluate clinical and surgical outcomes of surgically treated patients with FFP.

Methods

We retrospectively enrolled 14 patients, in our Trauma Center, underwent surgery procedures for FFP between 2012 and 2014. All patients attended clinical and radiological investigation at 1, 3, and 6 months postoperatively and every year after surgery with a mean follow-up of 22 months.

Results

At 6-month follow-up, 11 patients resulted asymptomatic: able to maintain standing position and walk without crunches. Two patients were able to walk with one crunch. The patient with history of previous acetabular fracture walks with two crunches and is still waiting for total hip arthroplasty.

Discussion

The compromised health status and the diminished bone-healing capacity, in elderly, decrease chances for a good clinical outcome. In literature, many authors suggest that mortality rate in patients with FFP is similar to those with hip fracture. Diagnosis of FFP is very important: these fractures are highly disabling in elderly and can lead to displacement and instability. For these reasons, correct diagnosis and well-conduct preoperative plan are necessary to improve stability of fractures and support bone healing. After diagnosis, an anti-osteoporotic treatment is indicated to improve bone quality and bone healing.

Conclusions

Our study shows encouraging results and demonstrates that minimally or less invasive osteosynthesis technique could lead to good outcome in these patients.

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Correspondence to M. Arduini.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Arduini, M., Saturnino, L., Piperno, A. et al. Fragility fractures of the pelvis: treatment and preliminary results. Aging Clin Exp Res 27 (Suppl 1), 61–67 (2015). https://doi.org/10.1007/s40520-015-0430-4

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  • DOI: https://doi.org/10.1007/s40520-015-0430-4

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