Pelvic Fractures:Low Impact

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Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton, Mahbubur Rahman and Kim Jackson  

Introduction

Due to the increasing life expectancy we are seeing more fragility fractures of the pelvis (FFPs). Studies have shown a significant increase in low-energy pelvic ring injuries in ages 60 and older. These kinds of fractures are the result of a low-energy impact or they may even occur spontaneously in patients with severe osteoporosis.

• Due to some distinct differences, the established classifications for pelvic ring lesions in younger adults do not fully reflect the clinical and morphological criteria of FFPs. Most FFPs are minimally displaced and do not require surgical therapy.
• Low-energy fractures of the elderly population sustained from a ground level fall frequently result in pelvic fractures that do not damage the true integrity of the ring structure and are often treated non-operatively. These fractures include superior and inferior pubic rami fractures as well as non-displaced sacral alar fractures.
• In some patients, an insidious progress of bone damage leads to increasing displacement, nonunion and persisting instability. New concepts for surgical treatment have to be developed to address the functional needs of the elderly patients.

Expected Outcomes/Mortality Rates

• Low-energy pelvic injuries do not appear to increase rate of mortality (compared to the US population).
• Fracture pattern, race, sex, discharge disposition and length of stay do not seem to have an effect on mortality.
• Elderly patients with an average age of 84.5 years and more than two comorbidities had higher rates of mortality; however, these patients were likely to sustain earlier mortality regardless of low-energy pelvic fracture.

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