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Background <p>The treatment of fragility fractures of the pelvis (FFP) is becoming increasingly more important due to the demographic changes. Older age and the associated multimorbidity pose a&#xa0;challenge for the optimal treatment of pelvic fractures.</p> Method <p>A&#xa0;total of 36&#xa0;patients were included. They were categorized according to the FFP classification with the following distribution: 44.4% FFP&#xa0;II, 16.7% FFP&#xa0;III and 38.9% FFP&#xa0;IV. Transiliosacral screws used unilaterally/bilaterally (cannulated 7.3 mm titanium screws with 32 mm thread, MedTech J&amp;J, Umkirch, Germany) were compared to a&#xa0;continuous transiliosacral sacral rod (cannulated 7.5 mm rod, Marquardt, Spachingen, Germany) for stabilization of the posterior pelvic ring (screw vs. rod) and in combination with or without a&#xa0;ventral supra-acetabular external fixator (steel Schanz screws with cross-connectors classified as ⌀Fix vs. Fix). The parameters measured were the duration of surgery, complication and revision rates and functional outcomes. The quality of life on the visual analogue scale (EQ-VAS), EQ-5D-5L index and Elderly Mobility Scale (EMS) were compared 1&#xa0;day, 6&#xa0;weeks and 6&#xa0;months postoperatively.</p> Results <p>The mean age of the overall cohort was 81.5 ± 7.7&#xa0;years and the overall mortality rate was 5.6%. The higher complication (29.4% vs. 17.6%, <i>p</i> = 0.419) and revision rates (5.9% vs.&#xa0;0.0%, <i>p</i> = 0.310) of the screw group were not statistically significant. The EQ-VAS, EQ-5D-5L and EMS showed no significant differences between screw vs. rod. The fix group had a&#xa0;longer operation time (47.2 ± 9.2 min vs. 35.2 ± 20.2 min, <i>p</i> = 0.005) but a&#xa0;lower complication rate (11.1% vs. 28.0%, <i>p</i> = 0.306); however, their mobility was significantly reduced postoperatively and after 6&#xa0;weeks (EMS day&#xa0;1: 6 ± 4 vs.&#xa0;11 ± 4, <i>p</i> = 0.003; week&#xa0;6: 12 ± 2 vs.&#xa0;16 ± 3, <i>p</i> = 0.010).</p> Discussion <p>Osteoporosis treatment had not been performed prior to the injury in 64.7% of the injured patients, 29.4% received a basic treatment for osteoporosis and 5.9% received specific treatment for osteoporosis. Surgical treatment of FFP&#xa0;II–IV showed a&#xa0;good clinical outcome with age-appropriate values after 6&#xa0;months. The clinical outcome was the same after 6&#xa0;months regardless of the surgical procedure.</p>

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Die chirurgische Stabilisierung von Fragilitätsfrakturen des Beckenrings zeigt unabhängig vom Operationsverfahren ein gutes altersentsprechendes Ergebnis

  • 期刊论文

  • 发表日期：

    2026年1月23日

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  • Anne Sofie Vogelsang,
  • Mikolaj Bartosik,
  • Eckart Mayr,
  • Ulf Culemann

摘要

Background

The treatment of fragility fractures of the pelvis (FFP) is becoming increasingly more important due to the demographic changes. Older age and the associated multimorbidity pose a challenge for the optimal treatment of pelvic fractures.

Method

A total of 36 patients were included. They were categorized according to the FFP classification with the following distribution: 44.4% FFP II, 16.7% FFP III and 38.9% FFP IV. Transiliosacral screws used unilaterally/bilaterally (cannulated 7.3 mm titanium screws with 32 mm thread, MedTech J&J, Umkirch, Germany) were compared to a continuous transiliosacral sacral rod (cannulated 7.5 mm rod, Marquardt, Spachingen, Germany) for stabilization of the posterior pelvic ring (screw vs. rod) and in combination with or without a ventral supra-acetabular external fixator (steel Schanz screws with cross-connectors classified as ⌀Fix vs. Fix). The parameters measured were the duration of surgery, complication and revision rates and functional outcomes. The quality of life on the visual analogue scale (EQ-VAS), EQ-5D-5L index and Elderly Mobility Scale (EMS) were compared 1 day, 6 weeks and 6 months postoperatively.

Results

The mean age of the overall cohort was 81.5 ± 7.7 years and the overall mortality rate was 5.6%. The higher complication (29.4% vs. 17.6%, p = 0.419) and revision rates (5.9% vs. 0.0%, p = 0.310) of the screw group were not statistically significant. The EQ-VAS, EQ-5D-5L and EMS showed no significant differences between screw vs. rod. The fix group had a longer operation time (47.2 ± 9.2 min vs. 35.2 ± 20.2 min, p = 0.005) but a lower complication rate (11.1% vs. 28.0%, p = 0.306); however, their mobility was significantly reduced postoperatively and after 6 weeks (EMS day 1: 6 ± 4 vs. 11 ± 4, p = 0.003; week 6: 12 ± 2 vs. 16 ± 3, p = 0.010).

Discussion

Osteoporosis treatment had not been performed prior to the injury in 64.7% of the injured patients, 29.4% received a basic treatment for osteoporosis and 5.9% received specific treatment for osteoporosis. Surgical treatment of FFP II–IV showed a good clinical outcome with age-appropriate values after 6 months. The clinical outcome was the same after 6 months regardless of the surgical procedure.