PLoS ONE (Jan 2021)

Operative treatment of fragility fractures of the pelvis is connected with lower mortality. A single institution experience.

  • Pol Maria Rommens,
  • Mehdi Boudissa,
  • Sven Krämer,
  • Miha Kisilak,
  • Alexander Hofmann,
  • Daniel Wagner

DOI
https://doi.org/10.1371/journal.pone.0253408
Journal volume & issue
Vol. 16, no. 7
p. e0253408

Abstract

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BackgroundFragility fractures of the pelvis (FFP) represent an increasing clinical entity. Until today, there are no guidelines for treatment of FFP. In our center, recommendation for operative treatment was given to all patients, who suffered an FFP type III and IV and to patients with an FFP type IIwith unsuccessful non-operative treatment. We performed a retrospective observational study and investigated differences between fracture classes and management alternatives. We hypothetized that operative treatment may reduce mortality.Materials and methodsThe medical charts and radiographs of 362 patients were analysed. Patient demographics, FFP-classification, length of hospital stay (LoS), type of treatment, general and surgery-related complications, mortality, Short Form-8 physical component score (SF-8 PCS) and mental component score (SF-8 MCS), Parker Mobility Score (PMS) and Numeric Rating Scale (NRS) were documented.Results238 patients had FFP type II and 124 FFP type III and IV. 52 patients with FFP type II (21.8%) and 86 patients with FFP type III and IV (69.4%) were treated operatively (pConclusionIn our study, we observed that operative treatment of FFP provides low mortality rates, although LoS and in-hospital complications were higher in the operative group. At discharge, the non-operative group was more mobile and independent. At follow up, quality of life and mobility were comparable between the groups. Further prospective studies are needed to clarify the impact of operative treatment of FFP on mortality and functional outcome.