Fragility fractures of the pelvis: treatment and preliminary results.
BACKGROUND
With increasing life expectancy, fragility fractures of the pelvic ring (FFP) are becoming frequent. In elderly, osteoporosis leads to a decrease of bone strength and resistance to the ligament's traction; this represents the most important difference between FFP and fractures in young patients. Usually, these fractures are underestimated and treatment is often conservative.


OBJECTIVE
To evaluate clinical and surgical outcomes of surgically treated patients with FFP.


METHODS
We retrospectively enrolled 14 patients, in our Trauma Center, underwent surgery procedures for FFP between 2012 and 2014. All patients attended clinical and radiological investigation at 1, 3, and 6 months postoperatively and every year after surgery with a mean follow-up of 22 months.


RESULTS
At 6-month follow-up, 11 patients resulted asymptomatic: able to maintain standing position and walk without crunches. Two patients were able to walk with one crunch. The patient with history of previous acetabular fracture walks with two crunches and is still waiting for total hip arthroplasty.


CONCLUSIONS
The compromised health status and the diminished bone-healing capacity, in elderly, decrease chances for a good clinical outcome. In literature, many authors suggest that mortality rate in patients with FFP is similar to those with hip fracture. Diagnosis of FFP is very important: these fractures are highly disabling in elderly and can lead to displacement and instability. For these reasons, correct diagnosis and well-conduct preoperative plan are necessary to improve stability of fractures and support bone healing. After diagnosis, an anti-osteoporotic treatment is indicated to improve bone quality and bone healing.


CONCLUSIONS
Our study shows encouraging results and demonstrates that minimally or less invasive osteosynthesis technique could lead to good outcome in these patients.
Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, "Policlinico Tor Vergata" Foundation, Rome, Italy. mario.arduini@gmail.com.
M
M
Arduini
Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, "Policlinico Tor Vergata" Foundation, Rome, Italy.
L
L
Saturnino
Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, "Policlinico Tor Vergata" Foundation, Rome, Italy.
A
A
Piperno
Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, "Policlinico Tor Vergata" Foundation, Rome, Italy.
R
R
Iundusi
Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, "Policlinico Tor Vergata" Foundation, Rome, Italy.
U
U
Tarantino
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods / Q000534:rehabilitation; D054624:Health Status Disparities; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D020380:Needs Assessment; D010024:Osteoporosis / Q000150:complications / Q000517:prevention & control; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery; D010384:Pelvic Bones / Q000293:injuries / Q000601:surgery; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D016138:Walking
Fragility pelvic fracture; Osteoporosis; Pelvic fracture outcome; Surgical treatment