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老年患者骨盆脆性骨折的功能治疗策略。

Functional treatment strategy for fragility fractures of the pelvis in geriatric patients.

机构信息

Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.

出版信息

Eur J Trauma Emerg Surg. 2021 Feb;47(1):21-27. doi: 10.1007/s00068-020-01484-0. Epub 2020 Aug 30.

Abstract

PURPOSE

We propose a functional treatment strategy for fragility fractures of the pelvis (FFP) in geriatric patients; patients with such fractures normally undergo 10 days of conservative therapy with full-weight bearing within pain limits. Conservative therapy for FFP is continued for patients who can stand with assistance, and surgical stabilization is recommended for patients with difficulty in auxiliary standing at 10 day postadmission. This study aimed to compare the outcomes of functional treatment between geriatric patients with FFP type I/II and those with FFP type III/IV, as described by Rommens et al. METHODS: We conducted a retrospective study of 84 geriatric patients who underwent functional treatment for FFP. Based on the results of the first examination, the patients were allocated to the following FFP types: type I/II (n = 53) and type III/IV (n = 31). Change in functional mobility scale described by Graham et al. from before injury to the final follow-up were compared between the groups.

RESULTS

There was no significant difference in the functional mobility scale (0.25 ± 0.70 vs. 0.23 ± 0.56, p = 0.889) between FFP type I/II and FFP type III/IV.

CONCLUSION

The outcomes of the functional treatment for FFP for the geriatric patients did not differ significantly between the radiographic classifications. Functional treatment could, therefore, be a treatment option for almost all radiographic types of FFP, especially for geriatric patients. Further investigations are warranted.

摘要

目的

我们提出了一种针对老年骨盆脆弱性骨折(FFP)的功能治疗策略;此类骨折患者通常接受 10 天的保守治疗,疼痛范围内可完全负重。对于能够在辅助下站立的患者,继续进行 FFP 的保守治疗,对于入院后 10 天辅助站立困难的患者,建议进行手术稳定。本研究旨在比较 Rommens 等人描述的 I/II 型和 III/IV 型 FFP 老年患者的功能治疗结果。

方法

我们对 84 例接受 FFP 功能治疗的老年患者进行了回顾性研究。根据首次检查结果,将患者分为以下 FFP 类型:I/II 型(n=53)和 III/IV 型(n=31)。比较两组 Graham 等描述的功能移动量表在受伤前和最终随访时的变化。

结果

I/II 型 FFP 和 III/IV 型 FFP 之间的功能移动量表(0.25±0.70 与 0.23±0.56,p=0.889)无显著差异。

结论

对于老年患者的 FFP 功能治疗结果,影像学分类之间没有显著差异。因此,功能治疗几乎可以作为所有影像学类型的 FFP 的治疗选择,尤其是对于老年患者。需要进一步研究。

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