[Sacral fractures in geriatric patients]

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Radiology

Background:

• Sacral fractures in geriatric patients are an increasing concern, presenting unique diagnostic and therapeutic challenges.
• Clinical presentation is often nonspecific, leading to delayed or missed diagnoses.
• Geriatric pelvic fractures require a comprehensive assessment of the entire pelvic ring for stability.

Purpose of the Study:

• To highlight the diagnostic and management strategies for sacral fractures in the elderly.
• To emphasize the importance of evaluating pelvic ring stability in geriatric patients.
• To provide guidance on treatment decisions based on fracture characteristics and patient condition.

Main Methods:

• Initial diagnosis relies on plain X-radiography.
• Sectional imaging is frequently required for detailed assessment of the posterior pelvic ring.
• The fragility fractures of the pelvis (FFP) classification system guides surgical treatment decisions.

Main Results:

• Stable fractures without significant displacement are managed conservatively after initial mobilization.
• Surgical intervention is indicated for pelvic ring instability, failed mobilization, or persistent pain.
• The degree of fracture displacement dictates the feasibility of minimally invasive versus complex open surgical procedures.

Conclusions:

• Accurate assessment of the geriatric pelvic ring is mandatory for appropriate treatment planning.
• The FFP classification aids in selecting conservative or surgical management strategies.
• Treatment ranges from conservative care for stable fractures to complex open procedures for unstable fractures requiring spinopelvic fixation.