Rommens Pol M, Arand Charlotte, Thomczyk Susanne, Handrich Kristin, Wagner Daniel, Hofmann Alex
Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland.
Unfallchirurg. 2019 Jun;122(6):469-482. doi: 10.1007/s00113-019-0643-7.
Fragility fractures of the pelvis are increasing in frequency. In most cases patients suffer a minor injury, have intense pain in the pelvic region and impaired mobility. The new fragility fractures of the pelvis (FFP) classification distinguishes between four types with increasing instability. The FFP types I and II are treated conservatively. For FFP types III and IV and type II with unsuccessful conservative treatment, minimally invasive stabilizing techniques are recommended. Both the posterior and anterior pelvic ring must be stabilized. Alternative techniques for dorsal stabilization are iliosacral screw and transsacral bar osteosynthesis, transiliac internal fixator and lumbopelvic fixation. External fixation, retrograde transpubic screw fixation, anterior internal fixation and plate and screw osteosynthesis are alternatives for the anterior pelvic ring. Treatment of fragility fractures of the pelvis should be carried out as part of an orthogeriatric co-management.
骨盆脆性骨折的发生率正在上升。在大多数情况下，患者遭受轻微损伤，骨盆区域剧痛且行动不便。新的骨盆脆性骨折（FFP）分类将四种类型按不稳定程度递增进行区分。FFP I型和II型采用保守治疗。对于FFP III型和IV型以及保守治疗失败的II型，建议采用微创稳定技术。骨盆前后环均须稳定。背侧稳定的替代技术有髂骶螺钉和经骶骨棒接骨术、经髂内固定器和腰骶固定。外固定、逆行耻骨螺钉固定、前路内固定以及钢板螺钉接骨术是骨盆前环的替代方法。骨盆脆性骨折的治疗应作为老年骨科联合管理的一部分来进行。
