Mobility and mortality of 340 patients with fragility fracture of the pelvis
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ORIGINAL ARTICLE
Mobility and mortality of 340 patients with fragility fracture of the pelvis Masahiro Yoshida1 · Kosuke Tajima1 · Yuki Saito1,2 · Koji Sato1,2 · Norimichi Uenishi1 · Mitsunaga Iwata1 Received: 6 April 2020 / Accepted: 24 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate prognosis of patients with fragility fracture of the pelvis (FFP) treated in a single trauma unit in Japan. Methods We retrospectively investigated 340 consecutive patients with FFP (40 men, 300 women; average age, 82.5 years) treated in our facility from April 2012 to April 2019. Fractures were categorized according to the Rommens classification. Patients’ mechanism of injury, existence of hip implant, standing and walking abilities (using the Majeed score), and 1-year mortality rate were evaluated. Results According to the Rommens classification, there were 84 type Ia, 2 type Ib, 24 type IIa, 78 type IIb, 51 type IIc, 40 type IIIa, 1 type IIIb, 4 type IIIc, 1 type IVa, 51 type IVb, and 3 type IVc fractures. Sixteen patients (4.7%) received surgical treatments. Twenty-eight patients (8.2%) had no memory of a traumatic event, and 61 (18%) had implants from a previous hip surgery. A total of 176 patients (52%) were followed up for ≥ 1 year, and 70 (39.8%) and 67 (38.1%) patients had recovery of standing and walking abilities, similar to those before the injury. The operative group (7/9 = 77.8%) had a higher proportion of patients who regained their standing and walking abilities at the 1-year follow-up than the conservative group. The 1-year mortality rate of the patients who could be followed for ≥ 1 year was 6.7%. Conclusion According to our data, 4.7% of patients were indicated for surgery, and only 1 week after the injury [5, 6]; however, patients’ age and medical condition differ individually, and surgery cannot be applied to all cases. At present, the original classification of the FFP is advocated by Rommens et al. [7]. Unlike pelvic fractures caused by a high-energy injury, this classification is based on a consecutive series of 245 patients with low-energy pelvic ring injuries aged ≥ 65 years who were treated in a single trauma unit in Germany. Moreover, there is no report in Japan at present of a large survey that investigated the fracture classification, natural progress, and life prognosis of ≥ 300 FFP cases. Here, we aimed to investigate the prognosis of 340 consecutive patients with FFP who were treated in a single trauma unit in Japan.
Patients and methods This retrospective study was conducted in accordance with the guidelines of the ethics committees of our institution. A total of 340 patients with FFP, including 40 men and 300 women with an average age of 82.5 years (range 65–102 years), who were treated in our facility from April 2012 to April 2019 were included in the study. Patients (n = 30) who had not undergone a pelvic computed tomography (CT) examination on admission were excluded. The fractures were classified according to the Rommens classificat
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