Noser Jonas, Dietrich Michael, Tiziani Simon, Werner Clément M L, Pape Hans-Christoph, Osterhoff Georg
Department of Trauma, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Department of Orthopaedics and Traumatology, Clinic for Surgery, Waid City Hospital, Zurich, Switzerland.
Injury. 2018 Nov;49(11):2032-2035. doi: 10.1016/j.injury.2018.09.017. Epub 2018 Sep 11.
Early operative treatment of fragility fractures of the pelvis (FFP) has been suggested to reduce pain and allow for earlier mobilization. The aim of this study was to determine mortality and functional outcome after operative treatment.
Patients aged ≥60 years (n = 60; mean age 79 years, 53 female) who had operative treatment of a FFP and a follow-up of at least 2 years were identified and mortality was assessed using a national social insurance database. Those who had survived were contacted by phone and a modified Majeed Score was obtained.
At final follow up (62 months, range, 29-117), 32 patients (53.3%) had deceased. One-year-mortality rate was 28.3% and 2-year mortality was 36.7%. Mortality was not linked to fracture type (p > .05). Complications during hospitalization occurred in 26/60 patients (43.3%). Patients with a bilateral FFP had a longer hospitalization (18 vs. 11 days; p = .021). The mean modified Majeed score of surviving patients was 65 points (85.5% of achievable maximum).
Mortality and in-hospital complications remain high among patients with FFP even when treated operatively. A longer hospitalization can be expected in patients with posterior bilateral fractures.
有人提出对骨盆脆性骨折（FFP）进行早期手术治疗可减轻疼痛并使患者更早活动。本研究的目的是确定手术治疗后的死亡率和功能结局。
确定年龄≥60岁（n = 60；平均年龄79岁，女性53例）且接受FFP手术治疗并至少随访2年的患者，并使用国家社会保险数据库评估死亡率。对存活的患者进行电话联系，获取改良的马吉德评分。
在末次随访时（62个月，范围29 - 117个月），32例患者（53.3%）已死亡。1年死亡率为28.3%，2年死亡率为36.7%。死亡率与骨折类型无关（p > 0.05）。60例患者中有26例（43.3%）在住院期间发生并发症。双侧FFP患者住院时间更长（18天对11天；p = 0.021）。存活患者的平均改良马吉德评分为65分（可达最高分的85.5%）。
即使接受手术治疗，FFP患者的死亡率和住院并发症仍然很高。双侧后部骨折患者预计住院时间更长。
