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骨盆骨折:流行病学、后果及医学处理

Pelvic fractures: epidemiology, consequences, and medical management.

作者信息

Breuil Véronique, Roux Christian Hubert, Carle Georges F

机构信息

aDepartment of Rheumatology, Nice University Hospital, Pasteur 2 Hospital Nice, France bUMR E-4320 TIRO-MATOs CEA/iBEB, Nice Sophia Antipolis University, Faculté de Médecine Nice, France.

出版信息

Curr Opin Rheumatol. 2016 Jul;28(4):442-7. doi: 10.1097/BOR.0000000000000293.

DOI:10.1097/BOR.0000000000000293
PMID:27077891
Abstract

PURPOSE OF REVIEW

Until recently, osteoporotic pelvic fractures have not been specifically studied. This review presents an update on epidemiological data of pelvic fracture, including morbidity, mortality and healthcare costs, the role of surgery and new data on sacroplasty in acute phase management.

RECENT FINDINGS

All studies underline the burden of osteoporotic pelvic fractures. Risk factors associated with these fractures are age, sex (women), and previous loss of autonomy. An increased mortality has been reported in all publications, similar to hip fracture for in-patient mortality and at 5 years of follow-up. Pelvic fractures often lead to transient or permanent autonomy loss, reflecting the high costs because of extended hospital stay, combined with nursing home requirement. However, recent studies report a decrease in the length of stay. Sacroplasty displays promising results to control pain and improve functional outcome. Early surgery begins to be discussed to also improve the outcome.

SUMMARY

Pelvic fractures display all the features of severe osteoporotic fractures: increased incidence, high morbidity, mortality, and healthcare costs that justify awareness of the practitioner on these fractures. Further studies on sacroplasty and surgery are necessary to improve pain control, functional improvement, thereby reducing the length of hospital stay and cost.

摘要

综述目的

直到最近,骨质疏松性骨盆骨折尚未得到专门研究。本综述介绍了骨盆骨折流行病学数据的最新情况,包括发病率、死亡率和医疗费用、手术的作用以及在急性期管理中关于椎体成形术的新数据。

最新发现

所有研究都强调了骨质疏松性骨盆骨折的负担。与这些骨折相关的危险因素包括年龄、性别(女性)和既往自主能力丧失。所有出版物都报告死亡率有所增加,住院死亡率和5年随访时的死亡率与髋部骨折相似。骨盆骨折常导致短暂或永久性自主能力丧失,这反映出由于住院时间延长以及需要入住疗养院而产生的高昂费用。然而,最近的研究报告住院时间有所缩短。椎体成形术在控制疼痛和改善功能结局方面显示出有希望的结果。也开始讨论早期手术以改善结局。

总结

骨盆骨折表现出严重骨质疏松性骨折的所有特征:发病率增加、高发病率、死亡率和医疗费用,这证明从业者应对这些骨折有所认识。有必要对椎体成形术和手术进行进一步研究,以改善疼痛控制、功能改善,从而缩短住院时间并降低成本。

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