Abstract
Background: Due to an aging society, more and more surgeons are confronted with fragility fractures of the pelvis (FFPs). The aim of treatment of such patients should be the quickest possible mobilization with full weight-bearing. Up to now however, there are no data on loading of the lower extremities in patients suffering FFPs. We hypothesized to find differences in loading of the lower limbs. Methods: 22 patients with a mean age of 84.1 years were included. During gait analysis with insole-force sensors, loading on the lower extremities was recorded during early mobilization after index fracture. Results: Especially the average peak force showed differences in loading, as the affected limb was loaded significantly less {59.78% (SD ± 16.15%) of the bodyweight vs. 73.22% (SD ± 14.84%) (p = <0.001, effect size r = 0.58)}. Furthermore, differences in loading in between the fracture patterns of FFPs were observed. Conclusion: This study shows that it is possible to reliably detect the extremity load, with the help of an insole device, in patients presenting with fragility fractures of the pelvis. There is great potential to improve the choice and time of treatment with insole-force sensors in FFPs in future.
Highlights
Fragility fractures of the pelvis (FFP) are one of the challenges in geriatric traumatology
22 consecutive FFP patients were included within the trial with a mean age of 84.09 years (SD ± 5.98, range 73–95 years). 90.9% of the patients were female (20 female/2 male) with an overall mean weight of 58.66 kg (SD ± 8.04 kg), a mean BMI of 22.45 kg/m2 (SD ± 3.35 kg/m2) and a mean ASA Score of 2.68 (SD ± 0.65) (Table 1)
The present study primarily proved feasibility of insole-force sensors that provide new treatment insights in fragility fractures of the pelvis
Summary
Fragility fractures of the pelvis (FFP) are one of the challenges in geriatric traumatology. There are two problems with the care of fragility fractures of the pelvis in older patients: first, the treatment of pelvic fractures is generally very demanding, even for experienced surgeons. This is made more difficult by reduced bone quality in the elderly. The goal in diagnosing and treating these patients must be to make a decision as quickly as possible regarding surgery or conservative therapy, so that they can be mobilized and return to their daily activity with compensated pain status This means that significant complications such as pneumonia, thrombosis and further muscle loss can be avoided during hospital stay and after discharge [6]. There is great potential to improve the choice and time of treatment with insole-force sensors in FFPs in future
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