Breuil Véronique, Roux Christian Hubert, Testa Jean, Albert Christine, Chassang Madleen, Brocq Olivier, Euller-Ziegler Liana
Department of Rheumatology, L'Archet 1 University Hospital, BP 3079 06202 Nice Cedex, France.
Joint Bone Spine. 2008 Oct;75(5):585-8. doi: 10.1016/j.jbspin.2008.01.024. Epub 2008 May 12.
The aim is to describe the characteristics of osteoporotic pelvic fractures and their outcome. We recorded clinical and biological characteristics of 60 osteoporotic pelvic fractures hospitalized in our Department of Rheumatology and assessed their outcome in 51 cases, using a questionnaire administrated by phone call. In our population, pelvic fractures mainly affected elderly women (81.6% of women, mean age 79 years), presenting, in more than 50% of the cases, a past medical history of osteoporosis, previous fracture and cardiovascular disease. The fractures were triggered by a fall in 89% of the cases and mainly located at the pubic rami (65%). There was a high rate of vitamin D deficiency (80.6%) associated with a secondary hyperparathyroidism (51.6%). Before the pelvic fracture, all patients lived at their personal home and 84.1% were autonomous. During hospitalization, 52.5% of the patients experienced an adverse event, mostly related to urinary tract infection and bedsore. At time to discharge, only 31% directly returned to their own home. At the final assessment (mean delay from the fracture: 29 months), 11 patients were dead (mean delay: 190 days). Among living patients, 74.5% lived at home, 60% required assistance for at least one daily life activity and 18.6% experienced a new fracture. Only 63.2% were still treated for osteoporosis. Osteoporotic pelvic fractures requiring initial hospitalization share most characteristics of hip fracture: elderly people, women predominance, vitamin D insufficiency, fall triggering the fracture, and also the severity assessed by a high morbidity and mortality and loss of autonomy.
目的是描述骨质疏松性骨盆骨折的特征及其预后。我们记录了在我们风湿科住院的60例骨质疏松性骨盆骨折的临床和生物学特征，并通过电话问卷调查评估了其中51例患者的预后。在我们的研究人群中，骨盆骨折主要影响老年女性（女性占81.6%，平均年龄79岁），超过50%的病例有骨质疏松、既往骨折和心血管疾病病史。89%的骨折由跌倒引发，主要位于耻骨支（65%）。维生素D缺乏率很高（80.6%），伴有继发性甲状旁腺功能亢进（51.6%）。骨盆骨折前，所有患者都住在自己家中，84.1%能够自理。住院期间，52.5%的患者发生不良事件，主要与尿路感染和压疮有关。出院时，只有31%的患者直接回到自己家中。在最终评估时（距骨折的平均时间：29个月），11例患者死亡（平均时间：190天）。在存活患者中，74.5%在家中生活，60%至少在一项日常生活活动中需要帮助，18.6%发生了新的骨折。仍在接受骨质疏松治疗的患者仅占63.2%。需要初次住院治疗的骨质疏松性骨盆骨折与髋部骨折具有大多数共同特征：老年人、女性居多、维生素D不足、跌倒引发骨折，以及高发病率、高死亡率和自主性丧失所评估的严重程度。
