Indications for surgical fixation of low-energy pelvic ring fractures in elderly: a systematic review.
Fragility
Geriatric
Indication
Osteoporosis
Pelvic fractures
Surgical fixation
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
26
11
2021
accepted:
30
03
2022
medline:
19
4
2023
pubmed:
26
4
2022
entrez:
25
4
2022
Statut:
ppublish
Résumé
There are no generally accepted criteria for when and how to fixate osteoporotic pelvic ring fractures in elderly. This systemic review aims to summarize the currently available literature regarding the indications and methods for surgical fixation of fragility fractures of the pelvic ring in elderly patients after low-energy trauma. The Pubmed and Embase databases were searched using the key words pelvic fractures, geriatric, fragility, osteoporosis, and surgical fixation, and their synonyms. Extracted data including the indication, method of operative fixation, and post-operative outcomes (pain levels, mobility, complications and mortality) were analyzed using descriptive statistics. The studies were too heterogeneous to perform a meta-analysis. Eleven cohort studies (3 comparative and 8 noncomparative) were included. The methodological quality was poor to moderate; the studies were heterogeneous regarding study design and reported outcomes. In all included studies operative treatment for all fracture types was preceded by a period of conservative treatment comprising physiotherapy-guided full weight-bearing. Time to surgery differed widely. For posterior ring fixation, the majority of the included studies used minimally invasive surgery with trans-iliosacral screws. Five studies described a form of additional fixation of the anterior pelvic ring but did not report the indications. Fixation of low-energy pelvic ring fractures in elderly is commonly performed after a period of conservative treatment, with persistent pain as the most frequent indication for fixation. Fracture classification based on stability seems to be of secondary importance. Timing for surgical fixation of the pelvic ring fracture in elderly patients remains diverse. Large well-designed comparative prospective studies and randomized controlled trials are needed to provide clearly substantiated guidelines.
Identifiants
pubmed: 35462589
doi: 10.1007/s00402-022-04438-w
pii: 10.1007/s00402-022-04438-w
pmc: PMC10110636
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2417-2428Informations de copyright
© 2022. The Author(s).
Références
Injury. 2018 Nov;49(11):2032-2035
pubmed: 30224176
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
J Orthop Trauma. 2021 Jan 1;35(1):e18-e24
pubmed: 32833697
ANZ J Surg. 2003 Sep;73(9):712-6
pubmed: 12956787
Curr Opin Rheumatol. 2016 Jul;28(4):442-7
pubmed: 27077891
Age Ageing. 2014 Sep;43(5):648-53
pubmed: 24419459
Eur J Trauma Emerg Surg. 2012 Oct;38(5):499-509
pubmed: 23162670
J Orthop Trauma. 2019 Nov;33(11):e410-e415
pubmed: 31633644
Injury. 2020 Feb;51(2):340-346
pubmed: 31879175
Injury. 2013 Dec;44(12):1733-44
pubmed: 23871193
J Orthop Surg (Hong Kong). 2019 Jan-Apr;27(1):2309499019833897
pubmed: 30862246
Spine (Phila Pa 1976). 2006 Jan 15;31(2):234-8
pubmed: 16418646
Injury. 2012 Apr;43(4):490-4
pubmed: 22281196
J Orthop Trauma. 2020 Nov;34(11):567-571
pubmed: 33065655
J Orthop Trauma. 2011 Sep;25(9):529-36
pubmed: 21857421
Injury. 2015 Aug;46(8):1631-6
pubmed: 26052052
Dtsch Arztebl Int. 2018 Feb 2;115(5):70-80
pubmed: 29439771
Arch Orthop Trauma Surg. 2021 Aug;141(8):1319-1324
pubmed: 32979063
Injury. 2017 Dec;48(12):2717-2723
pubmed: 29122281
J Orthop Trauma. 2019 Feb;33 Suppl 2:S55-S60
pubmed: 30688861
Swiss Med Wkly. 2013 Sep 19;143:w13859
pubmed: 24089312
Osteoporos Int. 2000;11(8):669-74
pubmed: 11095169
J Am Geriatr Soc. 2011 Jul;59(7):1309-12
pubmed: 21718260
Eur J Trauma Emerg Surg. 2022 Oct;48(5):3711-3719
pubmed: 33693977
Int Orthop. 2013 Jun;37(6):1147-50
pubmed: 23553117
Eur J Trauma Emerg Surg. 2021 Feb;47(1):37-45
pubmed: 33104870
Geriatr Orthop Surg Rehabil. 2020 Oct 21;11:2151459320967198
pubmed: 35186416
J Orthop Trauma. 2011 Jun;25(6):378-84
pubmed: 21577075
Injury. 2012 Aug;43(8):1326-9
pubmed: 22682148
J Orthop Trauma. 2018 Sep;32(9):452-456
pubmed: 29916895
Injury. 2019 Aug;50(8):1411-1417
pubmed: 31301810
Injury. 2019 Nov;50(11):1966-1973
pubmed: 31492514
Spine J. 2016 Feb;16(2):226-32
pubmed: 26282106
Injury. 2015 Oct;46 Suppl 4:S114-20
pubmed: 26542856
Oper Orthop Traumatol. 2019 Dec;31(6):491-502
pubmed: 31515581
Indian J Orthop. 2019 Jan-Feb;53(1):128-137
pubmed: 30905993
Eur J Trauma Emerg Surg. 2021 Feb;47(1):21-27
pubmed: 32862316
PLoS One. 2019 May 28;14(5):e0216809
pubmed: 31136589
JBJS Rev. 2017 Mar 21;5(3):
pubmed: 28359073