Functional treatment strategy for fragility fractures of the pelvis in geriatric patients

Eur J Trauma Emerg Surg. 2021 Feb;47(1):21-27. doi: 10.1007/s00068-020-01484-0. Epub 2020 Aug 30.

Abstract

Purpose: We propose a functional treatment strategy for fragility fractures of the pelvis (FFP) in geriatric patients; patients with such fractures normally undergo 10 days of conservative therapy with full-weight bearing within pain limits. Conservative therapy for FFP is continued for patients who can stand with assistance, and surgical stabilization is recommended for patients with difficulty in auxiliary standing at 10 day postadmission. This study aimed to compare the outcomes of functional treatment between geriatric patients with FFP type I/II and those with FFP type III/IV, as described by Rommens et al. METHODS: We conducted a retrospective study of 84 geriatric patients who underwent functional treatment for FFP. Based on the results of the first examination, the patients were allocated to the following FFP types: type I/II (n = 53) and type III/IV (n = 31). Change in functional mobility scale described by Graham et al. from before injury to the final follow-up were compared between the groups.

Results: There was no significant difference in the functional mobility scale (0.25 ± 0.70 vs. 0.23 ± 0.56, p = 0.889) between FFP type I/II and FFP type III/IV.

Conclusion: The outcomes of the functional treatment for FFP for the geriatric patients did not differ significantly between the radiographic classifications. Functional treatment could, therefore, be a treatment option for almost all radiographic types of FFP, especially for geriatric patients. Further investigations are warranted.

Keywords: Conservative treatment; Fragility fractures of the pelvis; Functional treatment strategy; Geriatric patient.

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Conservative Treatment*
  • Female
  • Fracture Fixation / methods*
  • Humans
  • Male
  • Osteoporotic Fractures / classification*
  • Osteoporotic Fractures / diagnostic imaging
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / therapy*
  • Pelvic Bones / diagnostic imaging
  • Pelvic Bones / injuries*
  • Retrospective Studies
  • Weight-Bearing