Surgical treatment of pelvic ring fractures in the elderly now and then: a pelvic registry study.

Abstract

With the demographic change, the treatment of elderly patients has become a major issue for health systems worldwide. The aim of this study was to analyze the change in the rate of surgical treatment of pelvic ring fractures in patients with an age of ≥60years over a 22-year period depending on fracture type, age and sex. Data of 5665 patients with an age of ≥60years, who were treated for pelvic ring fractures from 1991 to 2013 in one of 31 hospitals participating in the German Pelvic Trauma Registry, were included. The registry is divided into four time periods: t 1=1991-1993, t 2=1997-2000, t 3=2001-2008 and t 4=2009-2013. Data had been collected prospectively and was analyzed retrospectively, stratified for age and sex of the patients as well as type of fracture and mode of therapy (surgical vs. conservative). There was a significant increase (p<0.05) in the overall rate of surgical treatment. Nonetheless, during all time periods patients with an age of >70years were significantly less frequently surgically treated compared to 60- to 70-year-olds. Regardless of the fracture type, the rate of surgical treatment was significantly higher (p<0.05) in male compared to female patients during t 1. While this difference persisted for type A and type B fractures, the frequency of surgical treatment of type C fractures approximated in males and females. The present data indicate that the rate of surgical treatment of pelvic ring fractures in elderly patients has significantly increased over the 22-year period. Nonetheless, older patients (>70years) as well as female patients are still less frequently surgically treated.