Clinical experience in the treatment of fragility pelvic fractures

Abstract

Purpose of study: determine the optimal approach to the treatment of patients with pelvic fractures against a background of low bone mass. Patients and methods. During the period from 2017 to 2018, 64 patients were treated (average age 78±7.4 years) with fragility pelvic ring injuries. Fractures according to AO/OTA classification A2 - 5 (7.8%), B1 - 18 (28.1%), B2 - 28 (43.7%), B3 - 8 (12.5%), C1 - 3 (4.6%), C2 - 2 (3.1%). Long-term results were evaluated after 6 and 12 months, according to the Majeed scale and the «Timed up & go» test. Results. Intrahospital mortality was 7 (10.9%) people. The annual mortality rate was 31.2%. Results after a year were monitored in 44 patients. Good results in 40 patients, 3 satisfactory, 1 poor result. The previous level of activity was restored by 30 (68.1%) of 44 patients. Conclusion. The treatment of elderly patients with pelvic fractures on the background of osteoporosis should be multidisciplinary with the appointment of postoperative rehabilitation in specialized hospitals, comprehensive treatment of osteoporosis and therapist’s supervision to compensate for premorbid background. The decision on the final fixation of the pelvis should take into account the nature of the fracture, the degree of its stability, the level of patient activity before and after the injury, the degree of compensation of the general condition, the severity of osteoporosis.