Minimally invasive posterior locked compression plate osteosynthesis shows excellent results in elderly patients with fr
- PDF / 999,816 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 23 Downloads / 193 Views
ORIGINAL ARTICLE
Minimally invasive posterior locked compression plate osteosynthesis shows excellent results in elderly patients with fragility fractures of the pelvis Imke U. Schmerwitz1,2 · Philipp Jungebluth1 · Wolfgang Lehmann2 · Thomas J. Hockertz1 Received: 20 May 2020 / Accepted: 8 September 2020 © The Author(s) 2020
Abstract Purpose Fragility fractures of the pelvis (FFP) are common in older patients. We evaluated the clinical outcome of using a minimally invasive posterior locked compression plate (MIPLCP) as therapeutic alternative. Methods 53 Patients with insufficiency fractures of the posterior pelvic ring were treated with MIPLCP when suffering from persistent pain and immobility under conservative treatment. After initial X-ray, CT-scans of the pelvis were performed. In some cases an MRI was also performed to detect occult fractures. Postoperatively patients underwent conventional X-ray controls. Data were retrospectively analyzed for surgical and radiation time, complication rate, clinical outcome and compared to the literature. Results Patients (average age 79.1 years) underwent surgery with operation time of 52.3 min (SD 13.9), intra-operative X-ray time of 9.42 s (SD 9.6), mean dose length product of 70.1 mGycm (SD 57.9) and a mean hospital stay of 21.2 days (SD 7.7). 13% patients (n = 7) showed surgery-related complications, such as wound infection, prolonged wound secretion, irritation of the sacral root or clinically inapparent screw malpositioning. 17% (n = 9) showed postoperative complications (one patient died due to pneumonia 24 days after surgery, eight patients developed urinal tract infections). 42 patients managed to return to previous living situation. 34 were followed-up after a mean period of 31.5 (6–90) months and pain level at post-hospital examination of 2.4 (VAS) with an IOWA Pelvic Score of 85.6 (55–99). Conclusion We showed that MIPLCP osteosynthesis is a safe surgical alternative in patients with FFP 3 and FFP 4. This treatment is another way of maintaining a high level of stability in the osteoporotic pelvic ring with a relatively low complication rate, low radiation and moderate operation time and a good functional outcome. Keywords Fragility fracture · Sacrum · Insufficiency fracture · Posterior locked compression plate
Introduction Osteoporosis related fractures are common in older patients and its prevalence is rising with advancing age [1, 2]. Even though a high number of fractures involve the wrist, hip and spine the number of osteoporotic pelvic fractures including sacral and pubic rami fractures is likewise increasing rapidly * Imke U. Schmerwitz [email protected] 1
Department of Orthopedic Surgery, Sports Traumatology and Trauma Surgery, Staedtisches Klinikum Wolfenbuettel, Alter Weg 80, 38302 Wolfenbuettel, Germany
Department of Trauma, Orthopedic and Plastic Surgery, University Medical Center Goettingen, Goettingen, Germany
2
[3, 4]. The incidence of pelvic fractures in the German population aged 60 years or older was 22.4 per 10,000 per
Data Loading...
