Tran Duy Nguyen Anh, Hsu Chao-Yu, Rommens Pol Maria, Nguyen Tan Thanh, Kuo Yi-Jie, Cheng Shun-Jen, Chen Yu-Pin
The International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
EFORT Open Rev. 2025 Sep 4;10(9):709-717. doi: 10.1530/EOR-2024-0164.
This study investigates the 1-year mortality of fragility fractures of the pelvis (FFP) in patients categorized under this system and treated with surgery or conservative methods, aiming to assess the algorithm's effectiveness.
We systematically searched PubMed, Embase, Scopus, and Web of Science for English studies on the 1-year mortality of FFP, with no publication date restrictions. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled 1-year mortality rates were calculated using random-effects models. In addition, if applicable, odds ratios with 95% confidence intervals were employed. PRISMA guidelines were followed for reporting, and the study was registered with PROSPERO.
Analysis of 22 studies encompassing 3,265 patients with FFP revealed a concerning overall 1-year mortality rate of 15.5%. Mortality varied by fracture type, with FFP IV having the lowest rate (7.5%) and FFP III having the highest (17.0%). All studies concurred on conservative treatment for FFP I. For other fracture types, mortality rates differed between conservative and surgical approaches. Conservative treatment resulted in rates of 14.9, 21.8, and 5.1% for FFP II, III, and IV, respectively. Conversely, surgical treatment yielded mortality rates of 16.8, 19.5, and 24.2% for FFP II, III, and IV, respectively.
Fragility fractures of the pelvis have high mortality, especially in FFP III. Conservative treatment may be suitable for FFP I, while surgery might be better for FFP III. The rarity of FFP IV fractures limits conclusions, and FFP II fractures lack a clear treatment consensus. Further research is needed to optimize management for these fracture types.
本研究调查了在此系统分类下接受手术或保守治疗的骨盆脆性骨折（FFP）患者的1年死亡率，旨在评估该算法的有效性。
我们系统检索了PubMed、Embase、Scopus和Web of Science上关于FFP 1年死亡率的英文研究，无出版日期限制。使用纽卡斯尔-渥太华量表评估研究质量。采用随机效应模型计算合并的1年死亡率。此外，如适用，采用95%置信区间的比值比。遵循PRISMA指南进行报告，该研究已在PROSPERO注册。
对22项涵盖3265例FFP患者的研究分析显示，总体1年死亡率令人担忧，为15.5%。死亡率因骨折类型而异，FFP IV的死亡率最低（7.5%），FFP III的死亡率最高（17.0%）。所有研究都同意对FFP I采用保守治疗。对于其他骨折类型，保守治疗和手术治疗的死亡率有所不同。保守治疗导致FFP II、III和IV的死亡率分别为14.9%、21.8%和5.1%。相反，手术治疗导致FFP II、III和IV的死亡率分别为16.8%、19.5%和24.2%。
骨盆脆性骨折死亡率高，尤其是FFP III。保守治疗可能适用于FFP I，而手术治疗可能更适合FFP III。FFP IV骨折罕见限制了结论，FFP II骨折缺乏明确的治疗共识。需要进一步研究以优化这些骨折类型的管理。
