Osteoporotic Pelvic Fractures

Oberkircher, Ludwig; Ruchholtz, Steffen; Rommens, Pol Maria; Hofmann, Alexander; Bücking, Benjamin; Krüger, Antonio

doi:10.3238/arztebl.2018.0070

Cited by 77 publications

(107 citation statements)

References 43 publications

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“…Pelvis fractures constitute a significant clinical problem [6] [80] as they cause intense pain and immobility, impair the quality of life, and lead to loss of patients' independence [81]. In the elderly population, pelvis fractures are associated with a high morbidity and mortality with up to 27% of patients dying within 1 year of surgery [82,83].…”

Section: Pelvis Fracturesmentioning

confidence: 99%

“…The main objective of pelvic fracture treatment is pain relief and rapid mobilization with early full weight-bearing, as deemed appropriate regarding the patient's level of pain [83]. There is a need for specific surgical concepts for pelvic ring fractures in the elderly due to different fracture morphologies.…”

Section: Pelvis Fracturesmentioning

confidence: 99%

“…Clinically, screws often fail by loosening or unscrewing [85] due to reduced bone quality [81] which can be effectively addressed by using cannulated screws and bone cement to augment the fixation site [88,89]. Bone cement is also an option for isolated and incomplete compression fractures [83] in which the cement is injected via a needle accessing the sacrum via the sacrum ala. This sacroplasty technique has been effective in decreasing pain Fig.…”

Section: Pelvis Fracturesmentioning

confidence: 99%

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Biomechanics of Osteoporotic Fracture Fixation

Hollensteiner

Sandriesser

Bliven

et al. 2019

Curr Osteoporos Rep

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Purpose of Review Fractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures. Recent Findings Elderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fracture fixation that allows immediate post-operative weight-bearing. However, osteoporotic bone has decreased holding capacity for metallic implants and is thus associated with a considerable fracture fixation failure rate both short term and long term. Modern implant technologies with dedicated modifications provide sufficient mechanical stability to allow immediate weight-bearing for elderly individuals. Depending on fracture location and fracture severity, various options are available to reinforce or augment standard fracture fixation systems. Summary Correct application of the basic principles of fracture fixation and the use of modern implant technologies enables mechanically stable fracture fixation that allows early weight-bearing and results in timely fracture healing even in patients with osteoporosis.

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Section: Pelvis Fracturesmentioning

confidence: 99%

Section: Pelvis Fracturesmentioning

confidence: 99%

Section: Pelvis Fracturesmentioning

confidence: 99%

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Biomechanics of Osteoporotic Fracture Fixation

Hollensteiner

Sandriesser

Bliven

et al. 2019

Curr Osteoporos Rep

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“…A particular case is the fragility fracture of the pelvis (FFP) in which both diagnosis and treatment raises serious difficulties. In order to facilitate the diagnosis and subsequently to improve the treatment guides for FFP classification were developed [3]. According to the initial classification the pelvic fractures are: type A stable, type B unstable rotating, type C unstable rotating and vertical.…”

mentioning

confidence: 99%

Bisphosphonates Influence and Pain Assessment in Mobilization of Patients with Fragility Fracture of the Pelvis

Filip¹,

Veliceasa²,

Puha³

et al. 2019

Rev. Chim.

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Fragility fractures of the pelvis have lately gained interest due to the increased incidence caused by aging populations. The aim of the study was to evaluate the results of the therapy in patients with pelvic fragility fracture admitted between January 2015 and September 2018 St. Spiridon Emergency Hospital in Iasi in order to improve the therapeutic approach. We assessed the correlation between pain and the early mobilization under the weight bearing condition in patients with and without osteoporotic therapy in history. The study emphasizes the role of pain in recovery process and underline the serious consequences of the late detection of bone fragility. Our study had revealed that previous osteoporotic treatment has benefits in the event of a fracture. As a result of this analysis, we consider that the age for the prophylactic measures in bone fragility should go below 60 years.

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“…Fragility fracture occurs when structural changes suffered by the bone affect its biomechanical characteristics such as resistance to compression and torsional forces. The World Health Organization (WHO) defines a fragility fracture as one caused by a trauma that would be insufficient to injure bone if the bone substance were normal [1]. The most common fragility fractures are located in the vertebrae, femur, proximal humerus, distal radius.…”

mentioning

confidence: 99%

Calcium and Vitamin D Involvement in the Fragility Fracture of the Pelvis

Filip¹,

Alexa²,

Sîrbu³

et al. 2019

Rev. Chim.

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The fragility fracture is the widest spread of the bone diseases, in elderly. It particularly affects the vertebrae, the femur, the proximal humerus, the distal radius, the pelvis, thus preventing the patient�s free movement. The most debilitating of all these fractures is the fragility fracture of the pelvis. This type of fracture raises supplementary problems compared to the other fractures due to the difficulties of diagnosis, surgical approach and to the longer recovery period. Choosing the right treatment for FFP is difficult due to health and comorbidities in elderly patients. Both conservative and surgical therapy involve equally large risks: prolonged immobilization or surgical risks. Therefore, pharmacological therapy is an alternative to surgery. Bisphosphonates prove their utility in the fracture-healing outcome, but the influence of calcium and vitamin D were overlooked. The aim of our study was to evaluate the role of calcium and vitamin D in the healing process of patients with pelvic fragility fracture in osteoporotic patients with and without calcium and vitamin D supplementation. Our study shows that calcium and vitamin D exert a positive influence on the healing process of the fragility fractures and strongly emphasizes the need to educate patients to comply with the prescription to supplement calcium and vitamin D in order to improve fracture healing and prevent additional fractures.

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Osteoporotic Pelvic Fractures

Abstract: Retrospective analyses have shown that osteoporotic pelvic fractures are associated with decreased mobility and independence and with a one-year mortality ranging from 9.5% to 27%. Prospective therapeutic trials are urgently needed.

Cited by 77 publications

References 43 publications

Biomechanics of Osteoporotic Fracture Fixation

Biomechanics of Osteoporotic Fracture Fixation

Bisphosphonates Influence and Pain Assessment in Mobilization of Patients with Fragility Fracture of the Pelvis

Calcium and Vitamin D Involvement in the Fragility Fracture of the Pelvis

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