Epidemiology and Demographics

Abstract

Global population is growing in age. Osteoporosis is a disease that is related with aging. Fragility fractures of the pelvis have played a lesser role than the more prevalent hip, vertebral and upper extremity osteoporotic fractures. Due to better availability of CT scanners, pelvic fragility fractures are more frequently recognized as important osteoporotic fractures. Whereas the rates of geriatric hip fractures are on the decline over the past two decades, the incidence of pelvic ring fragility fractures is on the rise, especially in the higher age population. Various metabolic, rheumatologic, and oncologic disorders have been implicated in pelvic insufficiency fractures. There may be differential improvement in bone quality with the use of anti-resorptive and anabolic drugs, in which the proximal femur and vertebral bodies see greater improvement in bone mineral density compared to the pelvic ring and acetabulum, resulting in new and pathologic stresses felt by the pelvis. Mortality rates in patients, who sustain a pelvic ring injury, range from 9.5 to 18.9% in all patients over age 65 years to as great as 39% in elderly patients over age 90 years. There also is an impact on functional outcome. A large number of patients do not return to their pre-injury status.