Osche David B, Liodakis Emmanouil, Huber Stefan, Pohlemann Tim, Kleber Christian, Herath Steven C, Höch Andreas
Department of Trauma, Hand and Reconstructive Surgery, Saarland University Medical Center, 66421 Homburg, Germany.
AUC-Academy for Trauma Surgery, 80538 Munich, Germany.
J Clin Med. 2025 Apr 24;14(9):2935. doi: 10.3390/jcm14092935.
Fragility fractures of the pelvic ring (FFPs) represent a fast-growing entity in geriatric traumatology with increasing incidence worldwide. This study aimed to analyze the epidemiology, treatment concepts, and surgical strategies for FFPs based on data collected by the German Pelvic Multicenter Study Group documented in the German Pelvic Fracture Registry. It is the largest cohort study of its kind. This retrospective cohort study included patients aged 65 years or older after FFPs, as classified according to the Rommens and Hofmann classification. Data were collected from July 2018 onward and analyzed for demographics; fracture classifications; treatment modalities (operative vs. non-operative); and details of surgery, including timing and choice of implants. Patients after high-energy trauma were excluded. Statistical analyses included descriptive metrics and subgroup comparisons. Among 1242 patients (84% female; median age 83.4 years), FFP Type II was the most common fracture type (50.8%), followed by Type IV (21.1%). Non-operative management was employed in 68.8% of cases, while 30.9% underwent surgery. Surgical intervention was more frequent in higher-grade FFPs (e.g., 72.1% in Type IV). The most common surgical technique for the posterior pelvic ring was percutaneous screw fixation (61.3%), with navigation used in 47.4% of cases. This study highlights the variability in treatment strategies for FFPs, with conservative management predominating in lower-grade fractures and surgical approaches increasingly utilized for more complex cases. The findings underscore the need for standardized, evidence-based guidelines and further research to optimize treatment and long-term outcomes for geriatric patients with FFPs.
骨盆环脆性骨折（FFPs）在老年创伤学中是一个快速增长的病种，在全球范围内发病率不断上升。本研究旨在基于德国骨盆多中心研究组在德国骨盆骨折登记处记录的数据，分析FFPs的流行病学、治疗理念和手术策略。这是同类研究中规模最大的队列研究。这项回顾性队列研究纳入了65岁及以上的FFPs患者，按照罗曼斯和霍夫曼分类法进行分类。数据从2018年7月起开始收集，并对人口统计学、骨折分类、治疗方式（手术与非手术）以及手术细节（包括手术时机和植入物选择）进行分析。排除高能创伤后的患者。统计分析包括描述性指标和亚组比较。在1242例患者中（84%为女性；中位年龄83.4岁），II型FFP是最常见的骨折类型（50.8%），其次是IV型（21.1%）。68.8%的病例采用非手术治疗，而30.9%的患者接受了手术。在较高级别的FFPs中，手术干预更为频繁（例如，IV型中为72.1%）。骨盆后环最常见的手术技术是经皮螺钉固定（61.3%），47.4%的病例使用了导航技术。本研究强调了FFPs治疗策略的变异性，保守治疗在较低级别骨折中占主导地位，而手术方法在更复杂的病例中越来越多地被采用。研究结果强调了需要标准化的、基于证据的指南以及进一步的研究，以优化老年FFPs患者的治疗和长期预后。
