Bisphosphonates Influence and Pain Assessment in Mobilization of Patients with Fragility Fracture of the Pelvis

Alexandru Filip,Cristiana Filip,Ovidiu Alexa,Bogdan Puha,Bogdan Veliceasa,Dragos Popescu

doi:10.37358/rc.19.3.7071

Abstract

Fragility fractures of the pelvis have lately gained interest due to the increased incidence caused by aging populations. The aim of the study was to evaluate the results of the therapy in patients with pelvic fragility fracture admitted between January 2015 and September 2018 St. Spiridon Emergency Hospital in Iasi in order to improve the therapeutic approach. We assessed the correlation between pain and the early mobilization under the weight bearing condition in patients with and without osteoporotic therapy in history. The study emphasizes the role of pain in recovery process and underline the serious consequences of the late detection of bone fragility. Our study had revealed that previous osteoporotic treatment has benefits in the event of a fracture. As a result of this analysis, we consider that the age for the prophylactic measures in bone fragility should go below 60 years.

Highlights

Fragility fractures of the pelvis have lately gained interest due to the increased incidence caused by aging populations
In group II with patients not detected for osteoporosis before the fracture, the pain reach the mild range around the 10 days of hospitalization
From day 10, pain gradually decreases but remains in the mild range at a higher level for group II when compared to group I. These data suggest a significant change in bone structure, for group II, caused by osteoporosis not being diagnosed on time

Summary

Introduction

Fragility fractures of the pelvis have lately gained interest due to the increased incidence caused by aging populations. In order to assess the risk of fragility fracture, a number of guidelines (FRAX, CAROC) [1, 2] associate individual risk factors (sex, age, alcohol intake, drugs, etc.) with clinical factors (bone mineral density). A particular case is the fragility fracture of the pelvis (FFP) in which both diagnosis and treatment raises serious difficulties. According to the initial classification the pelvic fractures are: type A stable, type B unstable rotating, type C unstable rotating and vertical This classification did not reflect the severity of pelvic ring lesions in elderly patients. Phosphate groups confer bisphosphonates a strong affinity for bone hydroxyapatite crystals similar to that seen in endogenous pyrophosphate. AelRth2opuogshittiohne phosphate and hydroxyl groups are essential for the bisphosphonate affinity, the determine the anti-resorbtion structure of potency. TbhyeinRtr2omduocieintgy a nitrogen atom or an amino group at the anti-resorption capacity of BP increases bRy 2 position, the 10 to 10,000 fold compared to the non nitrogen-containing bisphosphonates [11] (fig. 3)

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