Which factors influence treatment decision in fragility fractures of the pelvis? - results of a prospective study

BMC Musculoskeletal Disorders

Juliana Hack¹  René Aigner¹  Steffen Ruchholtz¹  Julia Lenz¹  Ludwig Oberkircher¹  Christopher Bliemel¹  Daphne Eschbach¹  Benjamin Bücking²  Carsten Schoeneberg³ 

[1] Center for Orthopaedics and Trauma Surgery, Philipps University of Marburg, University Hospital Giessen and Marburg GmbH, Marburg, Germany;Department of Orthopaedics, Trauma Surgery and Geriatric Trauma, DRK-Hospital Nordhessen, Kassel, Germany;Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Essen, Germany;

关键词: Pelvis;    Fracture;    Fragility fracture;    Osteoporosis;    Treatment;    Sacral fracture;   

DOI  :  10.1186/s12891-021-04573-2

来源: Springer

【 摘 要 】

BackgroundThe aim of the present study was to describe specific characteristics of patients suffering from pelvic fragility fractures and evaluate factors that might influence treatment decisions which may optimize treatment pathways and patient mobility in the future.MethodsA prospective study with patients suffering from fractures of the pelvis and aged 60 years or above was performed between 2012 and 2016. Data acquisition took place at admission, every day during hospitalization and at discharge.ResultsOne hundred thirty-four patients (mean age of 79.93 (± 7.67) years), predominantly female (84%), were included. Eighty-six patients were treated non-operatively. Forty-eight patients underwent a surgical procedure. The main fracture types were B2 fractures (52.24%) and FFP IIb fractures (39.55%). At the time of discharge, pain level (NRS) could be significantly reduced (p <  0.001). Patients who underwent a surgical procedure had a significantly higher pain level on day three and four compared to the non-operative group (p = 0.032 and p = 0.023, respectively). Significant differences were found in the mobility level: patients treated operatively on day four or later were not able to stand or walk on day three as compared to non-operatively treated patients. Regarding B2 fractures, a significantly higher mobility level difference between time of admission and discharge was found in patients treated with a surgical procedure compared to patients treated non-operatively (p = 0.035).ConclusionsFracture type, mobility level and pain level influence the decision to proceed with surgical treatment. Especially patients suffering from B2 fractures benefitted in terms of mobility level at discharge when treated operatively.Level of evidenceII

【 授权许可】

CC BY