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Mobility and mortality of 340 patients with fragility fracture of the pelvis

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To investigate prognosis of patients with fragility fracture of the pelvis (FFP) treated in a single trauma unit in Japan.

Methods

We retrospectively investigated 340 consecutive patients with FFP (40 men, 300 women; average age, 82.5 years) treated in our facility from April 2012 to April 2019. Fractures were categorized according to the Rommens classification. Patients’ mechanism of injury, existence of hip implant, standing and walking abilities (using the Majeed score), and 1-year mortality rate were evaluated.

Results

According to the Rommens classification, there were 84 type Ia, 2 type Ib, 24 type IIa, 78 type IIb, 51 type IIc, 40 type IIIa, 1 type IIIb, 4 type IIIc, 1 type IVa, 51 type IVb, and 3 type IVc fractures. Sixteen patients (4.7%) received surgical treatments. Twenty-eight patients (8.2%) had no memory of a traumatic event, and 61 (18%) had implants from a previous hip surgery. A total of 176 patients (52%) were followed up for ≥ 1 year, and 70 (39.8%) and 67 (38.1%) patients had recovery of standing and walking abilities, similar to those before the injury. The operative group (7/9 = 77.8%) had a higher proportion of patients who regained their standing and walking abilities at the 1-year follow-up than the conservative group. The 1-year mortality rate of the patients who could be followed for ≥ 1 year was 6.7%.

Conclusion

According to our data, 4.7% of patients were indicated for surgery, and only < 40% of patients were able to regain their pre-injury standing and walking abilities at 1 year after the injury. FFP may greatly affect an elderly’s activities of daily living and may lead to prognosis similar to patients with proximal hip fractures. To regain the walking ability of patients with FFP, more aggressive indication of surgical treatment may be considered depending on the patient’s background. Further examinations are necessary to determine the surgical indications and treatment protocol for FFP.

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Authors and Affiliations

  1. Fujita Health University Hospital, Nagoya, Japan

    Masahiro Yoshida, Kosuke Tajima, Yuki Saito, Koji Sato, Norimichi Uenishi & Mitsunaga Iwata

  2. Japanese Red Cross Nagoya Daini Hospital Department of Orthopedics surgery, Nagoya, Aichi, Japan

    Yuki Saito & Koji Sato

Authors
  1. Masahiro Yoshida
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  2. Kosuke Tajima
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  3. Yuki Saito
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  4. Koji Sato
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  5. Norimichi Uenishi
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  6. Mitsunaga Iwata
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Correspondence to Masahiro Yoshida.

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Yoshida, M., Tajima, K., Saito, Y. et al. Mobility and mortality of 340 patients with fragility fracture of the pelvis. Eur J Trauma Emerg Surg 47, 29–36 (2021). https://doi.org/10.1007/s00068-020-01481-3

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  • DOI: https://doi.org/10.1007/s00068-020-01481-3

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