Functional treatment strategy for fragility fractures of the pelvis in geriatric patients
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ORIGINAL ARTICLE
Functional treatment strategy for fragility fractures of the pelvis in geriatric patients Kensuke Hotta1 · Takaomi Kobayashi1,2 Received: 26 June 2020 / Accepted: 24 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose We propose a functional treatment strategy for fragility fractures of the pelvis (FFP) in geriatric patients; patients with such fractures normally undergo 10 days of conservative therapy with full-weight bearing within pain limits. Conservative therapy for FFP is continued for patients who can stand with assistance, and surgical stabilization is recommended for patients with difficulty in auxiliary standing at 10 day postadmission. This study aimed to compare the outcomes of functional treatment between geriatric patients with FFP type I/II and those with FFP type III/IV, as described by Rommens et al. Methods We conducted a retrospective study of 84 geriatric patients who underwent functional treatment for FFP. Based on the results of the first examination, the patients were allocated to the following FFP types: type I/II (n = 53) and type III/ IV (n = 31). Change in functional mobility scale described by Graham et al. from before injury to the final follow-up were compared between the groups. Results There was no significant difference in the functional mobility scale (0.25 ± 0.70 vs. 0.23 ± 0.56, p = 0.889) between FFP type I/II and FFP type III/IV. Conclusion The outcomes of the functional treatment for FFP for the geriatric patients did not differ significantly between the radiographic classifications. Functional treatment could, therefore, be a treatment option for almost all radiographic types of FFP, especially for geriatric patients. Further investigations are warranted. Keywords Fragility fractures of the pelvis · Functional treatment strategy · Conservative treatment · Geriatric patient
Background Rommens et al. [1, 2] recently developed a radiographic classification for managing fragility fractures of the pelvis (FFP). Conservative therapy is recommended for FFP types I (anterior lesions only) and II (nondisplaced posterior lesions), whereas surgical stabilization is efficacious for FFP types III (displaced unilateral posterior lesions) and IV (displaced bilateral posterior lesions). Nevertheless, the
Kensuke Hotta and Takaomi Kobayashi authors equally contributed to this work. * Takaomi Kobayashi [email protected] 1
Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847‑8588, Japan
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5‑1‑1 Nabeshima, Saga 849‑8501, Japan
2
classification of FFP and its management remain a matter of debate [3, 4]. The radiographic classification of FFP and its management as recommended by Rommens et al. [1, 2] may exaggerate the role of surgical interventions for FFP [5–7]. Although various minimally invasive surgical stabilizations have been developed [8–11], postoperative complications (e.g., screw loosening) can oc
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