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老年骨质疏松性耻骨支骨折患者的隐匿性骨盆后环骨折

Occult posterior pelvic ring fractures in elderly patients with osteoporotic pubic rami fractures.

作者信息

Lau Tak-wing, Leung Frankie

机构信息

Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.

出版信息

J Orthop Surg (Hong Kong). 2010 Aug;18(2):153-7. doi: 10.1177/230949901001800205.

Abstract

PURPOSE

To evaluate postoperative walking status of elderly patients with osteoporotic pubic rami fractures with or without posterior pelvic ring fractures.

METHODS

33 women and 4 men aged 66 to 95 (mean, 85) years presented with osteoporotic pubic rami fractures after a fall. 22 (59%) of the patients had additional posterior pelvic ring fractures (9 had lateral compression type-II fractures involving the ilium and 13 had lateral compression type-I fractures involving the sacroalar region). Seven of the 9 patients with lateral compression type-II fractures underwent open reduction and internal fixation using plates and/ or screws. The remaining 30 patients were treated conservatively.

RESULTS

Postoperative walking status was similar in elderly patients with osteoporotic pubic rami fractures with or without posterior pelvic ring fractures.

CONCLUSION

Posterior pelvic ring fractures are easily missed in elderly patients with pubic rami fractures. Routine computed tomography of the pelvis is useful in making the diagnosis.

摘要

目的

评估伴有或不伴有骨盆后环骨折的老年骨质疏松性耻骨支骨折患者术后的行走状态。

方法

33名女性和4名男性,年龄66至95岁(平均85岁),因跌倒后出现骨质疏松性耻骨支骨折。22例(59%)患者伴有骨盆后环骨折(9例为累及髂骨的侧方压缩II型骨折,13例为累及骶髂区域的侧方压缩I型骨折)。9例侧方压缩II型骨折患者中的7例接受了钢板和/或螺钉切开复位内固定术。其余30例患者接受保守治疗。

结果

伴有或不伴有骨盆后环骨折的老年骨质疏松性耻骨支骨折患者术后行走状态相似。

结论

耻骨支骨折的老年患者容易漏诊骨盆后环骨折。骨盆常规计算机断层扫描有助于诊断。

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