Abstract
Purpose: Osteoporosis is a major risk factor for the development of fragility fractures of the pelvis (FFP). There is a lack of information about the influence of anatomical conditions such as Pelvic Incidence and Pelvic Ratio (DT/DS ratio) on this kind of fractures. Methods: This is a monocentric retrospective analysis. X-ray images of the lumbar spine and pelvis and 3D-MPR CT reconstructions of the pelvis were analysed to determine Pelvic Incidence (PI) and Pelvic Ratio (PR) in 141 fragility fractures of the pelvis. Statistical analyses were performed to examine the correlation between these spinopelvic parameters and fragility fractures of the pelvis. Results: A total of 141 fragility fractures of the pelvis (14 men = 9.93%, 127 women = 90.07%) were analysed. According to the FFP-classification we recognized FFP type 1 fractures in 19.15%, FFP type 2 in 41.13%, FFP type 3 in 8.51% and FFP type 4 fractures in 32.21%. The mean PI was 58.83º. There was no statistical correlation between PI and fracture types (p=0.81). The mean PR was 1.099. 57 patients (40.43%) demonstrated a DT/DS ratio ≤ 1.06, corresponding to a circle-type morphology. 24 patients (17.02%) demonstrated a DT/DS ratio ≥ 1.18, corresponding to an ellipse-type pelvis. A circle-type pelvis is significantly more often associated with fragility fractures of the pelvis than an ellipse-type morphology (p<0.001). Conclusion: The results of our work demonstrate a strong statistical correlation between the circle-type morphology of the pelvis (PR ≤ 1.06) and fragility fractures of the pelvis. There is no statistical correlation between fragility fractures of the pelvis and Pelvic Incidence.
Highlights
Fragility fractures of the pelvis represent an increasing focus in geriatric trauma centers
It has been proven that osteoporosis is a major risk factor for the development of these fractures. 60% of the fragility fractures of the pelvis are caused by osteoporosis [2,3,4,5]
We analysed the influence of Pelvic Incidence (PI) and Pelvic Ratio (PR) on fragility fractures of the pelvis (FFP)
Summary
Fragility fractures of the pelvis represent an increasing focus in geriatric trauma centers. The need for an interdisciplinary treatment and proper indication for non-operative therapy or surgery is the subject of the current literature This is well-founded in significant 1-year mortality, which is up to 27%, and the level of activity and desired quality of life in the elderly [1,2,3]. It has been proven that osteoporosis is a major risk factor for the development of these fractures. 60% of the fragility fractures of the pelvis are caused by osteoporosis [2,3,4,5]. To the authors’ opinion, it has not been sufficiently investigated if further and what kind of factors influence the development and course of these fractures. We analysed the influence of Pelvic Incidence (PI) and Pelvic Ratio (PR) on fragility fractures of the pelvis (FFP)
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