Lampert Christopher, Pachmann Florian, Rieger Johannes, Zhang Yunjie, Gleich Johannes, Stumpf Markus, Beckmann Johannes, Böcker Wolfgang, Neuerburg Carl, Linhart Christoph
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Munich, Germany.
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Munich, Germany.
Injury. 2025 Feb;56(2):112043. doi: 10.1016/j.injury.2024.112043. Epub 2024 Nov 26.
Fragility fractures of the pelvis (FFP) in elderly patients are an increasing concern due to their association with osteoporosis and the aging population. These fractures significantly affect patients' mobility and quality of life. This study evaluates different surgical techniques in patients suffering from FFP to provide standardized recommendations for treatment strategies. In addition, we compared therapeutic concepts and their outcome between two major trauma centers in Germany.
We conducted a retrospective analysis of 882 patients aged over 65 years who suffered from FFP between 2003 and 2020 at a level I and level III trauma center in a german metropolis. Fractures were classified according to Rommens and Hofmann. Data collection included patient demographics, fracture type, treatment strategy, and length of hospital stay.
FFP I fractures were predominantly treated conservatively at both centers. Significant variability was noted in the treatment of type II and III fractures, with level III trauma center having a higher surgical intervention rate for FFP II in 27.6 % compared to the level I trauma center in 9.9 % of the cases. The most common procedure at both hospitals was the stabilization of the posterior pelvic ring. Patients who underwent less invasive posterior-only stabilization had shorter length of hospital stay than those who received combined anterior and posterior stabilization.
The study reveals substantial differences in the treatment approaches for FFP between two major trauma centers. Less invasive surgical methods, particularly posterior-only stabilization, are associated with shorter hospital stays and potentially better outcomes for elderly patients with unstable FFP.
This study underscores the importance of minimally invasive surgical techniques in managing FFP in elderly patients, highlighting their potential to reduce the length of hospital stay and improve recovery.
老年患者骨盆脆性骨折（FFP）因其与骨质疏松症及人口老龄化相关，日益受到关注。这些骨折显著影响患者的活动能力和生活质量。本研究评估FFP患者的不同手术技术，为治疗策略提供标准化建议。此外，我们比较了德国两个主要创伤中心的治疗理念及其结果。
我们对2003年至2020年间在德国一座大都市的一级和三级创伤中心就诊的882例65岁以上FFP患者进行了回顾性分析。骨折根据罗曼斯和霍夫曼分类法进行分类。数据收集包括患者人口统计学、骨折类型、治疗策略和住院时间。
两个中心对FFP I型骨折主要采用保守治疗。II型和III型骨折的治疗存在显著差异，三级创伤中心对FFP II型骨折的手术干预率为27.6%，而一级创伤中心为9.9%。两家医院最常见的手术是骨盆后环稳定术。接受微创仅后路稳定术的患者住院时间比接受前后联合稳定术的患者短。
该研究揭示了两个主要创伤中心在FFP治疗方法上存在显著差异。微创外科手术方法，尤其是仅后路稳定术，与老年不稳定FFP患者住院时间缩短及潜在更好的预后相关。
本研究强调了微创外科技术在老年患者FFP治疗中的重要性，突出了其在缩短住院时间和改善恢复方面的潜力。
