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Review


doi: 10.1007/s11914-022-00760-9.


Online ahead of print.

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Review

Lynn Hutchings et al.


Curr Osteoporos Rep.


.

Abstract


Purpose of review:

To summarise the current evidence and clinical practices for patients with fragility fractures of the pelvis (FFP).


Recent findings:

FFPs are an increasingly prevalent and recognised problem in the elderly population. Recent evidence indicates they have a significant impact on function, morbidity and mortality. While traditional management of FFPs was predominantly non-surgical, surgical options have been increasingly used, with a range of surgical methods available. To date, limited consensus exists on the optimal strategy for suitable patient selection, and clinical trials in this population have proved problematic. The management of FFPs requires a multi-faceted approach to enhance patient care, including adequate pain control, minimisation of complications and optimisation of medical management. Early return to mobilisation should be a key treatment goal to maintain functional independence. The selection of patients who will maximally benefit from surgical treatment, and the most appropriate surgical strategy to employ, remains contentious.


Keywords:

Elderly; Fragility fractures of the pelvis (FFP); Osteoporosis; Pelvic fixation; Pelvic stabilisation; Percutaneous pelvic fixation.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

    1. Humphrey CA, Maceroli MA. Fragility fractures requiring special consideration: pelvic insufficiency fractures. Clin Geriatr Med. 2014;30(2):386. https://doi.org/10.1016/j.cger.2014.01.012 . This narrative review provides an overview of pelvic and acetabular fragility fractures including a summary of treatment goals.

    1. Dodge G, Brison R. Low-impact pelvic fractures in the emergency department. CJEM. 2010;12(6):509–13. https://doi.org/10.1017/s1481803500012732 .

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    1. Morris RO, Sonibare A, Green DJ, Masud T. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards. Postgrad Med J. 2000;76(900):646–50. https://doi.org/10.1136/pmj.76.900.646 .

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    1. Osterhoff G, Noser J, Held U, Werner CML, Pape HC, Dietrich M. Early operative versus nonoperative treatment of fragility fractures of the pelvis: a propensity-matched multicenter study. J Orthop Trauma. 2019;33(11):e410–e5. https://doi.org/10.1097/BOT.0000000000001584 .

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    1. Petryla G, Uvarovas V, Bobina R, Kurtinaitis J, Khan SA, Versocki A, Porvaneckas N, Šatkauskas I. The one-year mortality rate in elderly patients with osteoporotic fractures of the pelvis. Arch Osteoporos. 2020;15(1):15. https://doi.org/10.1007/s11657-020-0689-8 .

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