[Osteoporotic fractures of the pelvis].
The incidence of osteoporotic pelvic fractures is rapidly increasing. Following low energy trauma fractures are frequently classified as pelvic girdle fractures. Based on the pelvic expert group database of the German Trauma Society the estimated rate of osteoporotic pelvic ring fractures is about 51%. In cases of fractured pubic rami standard X-ray in anterior-posterior, inlet and outlet views should be carried out by computed tomography (CT) scanning to identify fractures of the sacrum. Only if pain persists and no fracture is evident with CT is magnetic resonance imaging (MRI) indicated. Therapy should be carried out under biomechanical instability aspects. Pubic rami fractures are stable and treated conservatively with sufficient pain medication, thromboembolic prophylaxis and physiotherapy. In cases of persisting pain or biomechanical instability operative treatment is indicated and stabilization methods should be chosen under biomechanical aspects. Therefore external fixator for pubic rami fractures and iliosacral screws, optionally with cement augmentation for posterior pelvic girdle fractures are the preferred techniques. Sacral fractures with severe osteolysis should be stabilized by lumbopelvic fixation techniques.
Klinik für Unfall-, Wiederherstellungs- und Plastische Chirurgie, Wirbelsäulenzentrum, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland. joerg.boehme@medizin.uni-leipzig.de
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D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019644:Arthroplasty, Replacement, Hip; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery*; D026741:Physical Therapy Modalities; D011379:Prognosis; D011630:Pubic Bone / Q000293:injuries / Q000601:surgery; D012447:Sacrum / Q000293:injuries / Q000601:surgery; D012737:Sex Factors; D014057:Tomography, X-Ray Computed