Pelvic ring fractures in the elderly. Underestimated osteoporotic fracture

被引:66
作者
Fuchs, T. [1 ]
Rottbeck, U. [1 ]
Hofbauer, V. [1 ]
Raschke, M. [1 ]
Stange, R. [1 ]
机构
[1] Univ Klinikum Munster, Klin Unfall Hand & Wiederherstellungschirurg, D-48149 Munster, Germany
来源
UNFALLCHIRURG | 2011年 / 114卷 / 08期
关键词
Pelvic ring fracture; Osteoporosis; Insufficiency fracture; Epidemiology; Treatment; SACRAL INSUFFICIENCY FRACTURES; ILIOSACRAL SCREWS; PLACEMENT; FIXATION; TRAUMA; CT; STABILIZATION; MULTICENTER; RADIOGRAPHY; MANAGEMENT;
D O I
10.1007/s00113-011-2020-z
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The incidence of pelvic fractures at 0.3-8% is low compared to all fractures. Nevertheless, the number of pelvic fractures in the elderly is increasing. Due to the increased age of the patient differences in trauma mechanism, fracture pattern and therapy occur. Most pelvic fractures in the elderly are caused by low-energy trauma. This makes it difficult to find the right diagnosis especially in insufficiency fracture of the pelvis. The time until the right treatment is started is prolonged significantly. Elderly patients who suffer from a high-energy fracture have a significantly higher risk of haemorrhage. At the same time emergency stabilisation of the pelvis using a C-clamp is dangerous due to the special fracture morphology with transiliac instabilities and the combination with osteoporosis. Low-energy trauma leads to simple fractures of the pubis, which often can be treated without operation. In these cases fractures of the dorsal pelvic ring need to be excluded using CT scan. Fracture of the dorsal part of the pelvic ring such as insufficiency fractures of the sacrum should be stabilized by 3D-guided percutaneous iliosacral screw fixation to reduce pain and allow early mobilisation.
引用
收藏
页码:663 / 670
页数:8
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