Clinical pathways for fragility fractures of the pelvic ring: personal experience and review of the literature

Fragility fractures of the pelvic ring (FFP) are increasing in frequency and require challenging treatment. A new comprehensive classification considers both fracture morphology and degree of instability. The classification system also provides recommendations for type and invasiveness of treatment....

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Bibliographic Details
Published in:Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2015-01, Vol.20 (1), p.1-11
Main Authors: Rommens, Pol M, Ossendorf, Christian, Pairon, Philip, Dietz, Sven-Oliver, Wagner, Daniel, Hofmann, Alexander
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Critical Pathways
Fracture Fixation, Internal
Fractures, Bone - diagnosis
Fractures, Bone - etiology
Fractures, Bone - surgery
Frail Elderly
Humans
Medicine
Medicine & Public Health
Orthopedics
Pelvic Bones
Review
Review Article
Rheumatology
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Summary:Fragility fractures of the pelvic ring (FFP) are increasing in frequency and require challenging treatment. A new comprehensive classification considers both fracture morphology and degree of instability. The classification system also provides recommendations for type and invasiveness of treatment. In this article, a literature review of treatment alternatives is presented and compared with our own experiences. Whereas FFP Type I lesions can be treated conservatively, FFP Types III and IV require surgical treatment. For FFP Type II lessions, percutaneous fixation techniques should be considered after a trial of conservative treatment. FFP Type III lesions need open reduction and internal fixation, whereas FFP Type IV lesions require bilateral fixation. The respective advantages and limitations of dorsal (sacroiliac screw fixation, sacroplasty, bridging plate fixation, transsacral positioning bar placement, angular stable plate) and anterior (external fixation, angular stable plate fixation, retrograde transpubic screw fixation) pelvic fixations are described.
ISSN:0949-2658
1436-2023
DOI:10.1007/s00776-014-0653-9