pelvic fractures in elderly patients often result in poor prognosis due to immobilization associated complications. Thus, the target of the treatment in this patient group is early mobilization in order to reduce the risk of these complications. We report outcomes of 4 cases of pelvic fracture in elderly patients, who were treated with percutaneous screw fixation. We examined medical records and images of 4 elderly patients between January 2012 and May 2012 in our center. Mean age of the patients was 88.8 years old (range 86–92 years). The causes of injury were motor vehicle accident in 3 patients, and a fall in 1 patient. Fracture types were ao type a in 1 patient, type b in 2 patients and type c in 1 patient. Mean injury severity score was 25 (10–57). We assessed functional status after the follow-up period using majeeds grading score for pelvic fractures.Background
Material and method
Much interest and controversy have arisen regarding treatment and prognosis of unstable pelvic fractures. The choice of treatment should be based to a large extent on the long-term outcome. Residual vertical displacement and sacroiliac joint involvement are often cited as being related to poor outcome. This study attempts to clarify whether residual vertical displacement or location of posterior pelvic ring injury correlate with functional outcomes. 33 patients with unstable pelvic fractures not involving the acetabulum were reviewed with greater than 18 months of follow-up. Iowa pelvic scores and descriptive information about sequelae were administered. Fractures were classified according to Tile as 27 type B, and 6 type C fractures. 9 cases were treated with external fixation and 5 cases were treated open reduction and internal fixation. The amount of residual vertical displacement was measured on plain AP radiographs and graded as 0–4,4–10,10–20, or >
20mm. Location of posterior pelvic ring injury was divided into 3 groups, sacral fractures, sacroiliac fracture dislocations, and transiliac fractures. Residual vertical displacement correlated with the incidence of LBP to some extent, but the difference was not statistically significant. Location of the posterior pelvic injury correlated with the incidence of neurologic injury and gait disturbance. There was high incidence of lower extremity fractures associated with the pelvic fractures. The incidence of gait disturbance and Iowa pelvic score were not valid as functional assessment tool. Residual vertical displacement and location of posterior pelvic injury correlated with the functional outcome to some extent.
