Does surgical treatment for unstable fragility fracture of the pelvis promote early mobilization and improve survival rate and postoperative clinical function?

被引:10
|
作者
Saito, Yuki [1 ]
Tokutake, Katsuhiro [2 ]
Takegami, Yasuhiko [1 ]
Yoshida, Masahiro [3 ]
Omichi, Toshifumi [1 ]
Imagama, Shiro [1 ]
机构
[1] Nagoya Univ, Grad Sch Med, Dept Orthoped Surg, Nagoya, Aichi, Japan
[2] Nagoya Univ, Grad Sch Med, Dept Hand Surg, Shouwa Ku, 65 Tsurumai cho, Nagoya, Aichi, Japan
[3] Fujita Hlth Univ Hosp, Dept Emergency Med, Nagoya, Aichi, Japan
关键词
Fragility fracture; Pelvis; Trauma; Rommens classification; PUBIC RAMI; MORTALITY; EPIDEMIOLOGY; DISPLACEMENT; ADMISSION; FIXATION; PATTERNS; OUTCOMES; FEMUR; NECK;
D O I
10.1007/s00068-021-01729-6
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose This retrospective multicenter study aimed to compare rates of early mobilization and survival and functional outcome of surgical treatment (S) with that of conservative treatment (C) according to each unstable fragility fracture of the pelvis (FFP) classification type with displacement of the posterior component >= 5 mm. Methods We analyzed 64 patients with unstable type III and IV FFP who could move and transfer themselves before injury and had >= 5 mm displacement of the posterior component. We compared survival rate, early mobilization, walking ability at final follow-up, and complications at admission for each type of surgical and conservative treatment. Results Most of the unstable FFP were type IIIa and IVb in the study population. Type III comprised 40 cases (group S:13/group C:27) and type IV comprised 24 cases (group S:7/group C:17). There were no significant differences in 3 month and 1 year survival rates, although group C (III) had the tendency of higher mortality rate (p = 0.08). Mobilization (transferring to a wheelchair) was enabled significantly earlier in group S (III) than in group C (III) (p = 0.02), but in type IV, most patients enabled early mobilization even without surgical intervention. There were no significant differences in hospital complications and walking ability at final follow-up. Conclusion In this study, the superiority of surgical treatment for unstable FFP was not proven. However, the results suggest that type IVb may be a relatively stable type compared to type III and that type IVb should be considered separately from bilaterally complete unstable sacral fractures due to high-energy trauma.
引用
收藏
页码:3747 / 3756
页数:10
相关论文
共 8 条
  • [1] Does surgical treatment for unstable fragility fracture of the pelvis promote early mobilization and improve survival rate and postoperative clinical function?
    Yuki Saito
    Katsuhiro Tokutake
    Yasuhiko Takegami
    Masahiro Yoshida
    Toshifumi Omichi
    Shiro Imagama
    European Journal of Trauma and Emergency Surgery, 2022, 48 : 3747 - 3756
  • [2] Comparison of two surgical treatment strategies for fragility fractures of the pelvis based on early postoperative mobility outcomes using insole force sensors
    Faust, L.
    Lebert, L.
    Pachmann, F.
    Boecker, W.
    Neuerburg, C.
    Keppler, A. M.
    ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2024, 145 (01)
  • [3] 850 Surgical Versus Non-Surgical Treatment of Unstable Lateral Compression Injuries of the Pelvis with Complete Sacral Fractures (LC1) in Non-Fragility Fracture Patients: A Systematic Review
    Varma, J.
    Foxall-Smith, M.
    Donovan, R.
    Whitehouse, M.
    Rogers, C.
    Acharya, M.
    BRITISH JOURNAL OF SURGERY, 2022, 109 (SUPPL 6)
  • [4] Surgical Versus Non-surgical Treatment of Unstable Lateral Compression Type I (LC1) Injuries of the Pelvis With Complete Sacral Fractures in Non-fragility Fracture Patients: A Systematic Review
    Varma, Jonny R.
    Foxall-Smith, Michael
    Donovan, Richard L.
    Whitehouse, Michael R.
    Rogers, Chris
    Acharya, Mehool
    CUREUS JOURNAL OF MEDICAL SCIENCE, 2022, 14 (09)
  • [5] CLINICAL-FEATURES AND WALKING ABILITY IN THE EARLY POSTOPERATIVE PERIOD AFTER TREATMENT OF TROCHANTERIC HIP-FRACTURES - RESULTS WITH SPECIAL REFERENCE TO FRACTURE TYPE AND SURGICAL-TREATMENT
    BROSTROM, LA
    BARRIOS, C
    KRONBERG, M
    STARK, A
    WALHEIM, G
    ANNALES CHIRURGIAE ET GYNAECOLOGIAE, 1992, 81 (01) : 66 - 71
  • [6] Application of Smart Healthcare in Comparative Analysis of Effect of Early External Fixator and Plate Internal Fixation Treatment on Postoperative Complications and Lower Limb Function Recovery of Patients With Unstable Pelvic Fracture
    Zhang, Hongwei
    Sun, Fang
    Li, Yao
    FRONTIERS IN PUBLIC HEALTH, 2022, 10
  • [7] Early surgical treatment using regional clinical pathways to reduce the length of postoperative hospital stay in hip fracture patients: A retrospective analysis using the Japanese Diagnosis Procedure Combination database
    Nishimura, Haruki
    Suzuki, Hitoshi
    Tokutsu, Kei
    Muramatsu, Keiji
    Kawasaki, Makoto
    Yamanaka, Yoshiaki
    Uchida, Soshi
    Nakamura, Eiichiro
    Fushimi, Kiyohide
    Matsuda, Shinya
    Sakai, Akinori
    PLOS ONE, 2024, 19 (07):
  • [8] BRONCHOGENIC CARCINOMA - STAGE 2 - RATIONALE AND BENEFIT OF PREOPERATIVE IRRADIATION IN LUNG CANCER - SURVIVAL RATE IN SUPERIOR SULCUS TUMORS TREATED BY PRESURGICAL IRRADIATION - PRESENT STATUS OF SURGICAL ADJUVANT LUNG-CANCER CHEMOTHERAPY - DOES POSTOPERATIVE IRRADIATION IMPROVE SURVIVAL IN LUNG CANCER - COMMENT - COMBINATION THERAPY-IRRADIATION SURGERY AND CHEMOTHERAPY
    RUBIN, P
    BLOEDORN, FG
    PAULSON, DL
    HUGHES, FA
    HIGGINS, G
    BEEBE, GW
    SHERRAHD.E
    RUBIN, P
    JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1966, 196 (04): : 339 - &