Abstract
BackgroundFragility fractures without significant trauma of the pelvic ring in older patients were often treated conservatively. An alternative treatment is surgery involving percutaneous screw fixation to stabilize the posterior pelvic ring. This surgical treatment enables patients to be mobilized quickly and complications associated with bedrest and temporary immobility are reduced. However, the functional outcome following surgery and quality of life of the patients have not yet been investigated. Here, we present a comprehensive study addressing the long-term well-being and the quality of life of patients with fragility pelvic ring fractures after surgical treatment.MethodsBetween 2011–2019, 215 geriatric patients with pelvic ring fractures were surgically treated at the university hospital in Göttingen (Germany). Of these, 94 patients had fragility fractures for which complete sets of computer tomography (CT) and radiological images were available. Fractures were classified according to Tile and according to the FFP classification of Rommens and Hofmann. The functional outcome of surgical treatment was evaluated using the Majeed pelvic score and the Short Form Health Survey-36 (SF-36).ResultsThirty five tile type C and 48 type B classified patients were included in the study. After surgery eighty-three patients scored in average 85.92 points (± 23.39) of a maximum of 100 points using the Majeed score questionnaire and a mean of 1.60 points on the numerical rating scale ranging between 0 and 10 points where 0 points refers to “no pain” and 10 means “strongest pain”. Also, the SF-36 survey shows that surgical treatment positively effects patients with respect to their general health status and by restoring vitality, reducing bodily pain and an increase of their general mental health.ConclusionsPatients who received a percutaneous screw fixation of fragility fractures of the posterior pelvic ring reported an overall positive outcome concerning their long-term well-being. In particular, older patients appear to benefit from surgical treatment.Trial registrationFunctional outcome and quality of life after surgical treatment of fragility fractures of the posterior pelvic ring, DRKS00024768. Registered 8th March 2021 - Retrospectively registered. Trial registration number DRKS00024768.
Highlights
Fragility fractures without significant trauma of the pelvic ring in older patients were often treated conservatively
Out of a total of 215 geriatric patients with injuries of the posterior pelvic ring, who were surgically treated during this period, 94 patients with fragility fractures of the posterior pelvic ring who had previously presented in the emergency department were included in the study
Ninety-four patients (mean age: 72.70 years; 59 females and 35 males) with fragility fractures of the posterior pelvic ring were included in the study
Summary
Fragility fractures without significant trauma of the pelvic ring in older patients were often treated conservatively. An alternative treatment is surgery involving percutaneous screw fixation to stabilize the posterior pel‐ vic ring. This surgical treatment enables patients to be mobilized quickly and complications associated with bedrest and temporary immobility are reduced. A reason is the low-energy trauma mechanism, which leads to fractures in bone with a lower bone density [1]. Such fractures, referred to as fragility fractures, could be both a symptom or a sign of osteoporosis. This conservative treatment is associated with potentially severe mid-term and long-term complications [4] including a high mortality rate, i.e. the mortality rate within one year after the fracture is reported to be 19% and even higher (27%) when patients lived on their own or in nursing homes after the fractured pelvis [3]
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