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Related Concept Videos

Fractures: Bone Repair01:27

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[Sacral fractures in geriatric patients].

Christine Kons1, Susanne Wicklein2, Roland Biber3

  • 1Klinik für Unfallchirurgie, Akademisches Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Kliniken Dr. Erler gGmbH, Kontumazgarten 4-19, 90429, Nürnberg, Deutschland.

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|May 31, 2022
PubMed
Summary

Sacral fractures in geriatric patients are often overlooked due to unspecific symptoms. Prompt evaluation of the entire pelvic ring and appropriate classification are crucial for guiding treatment decisions and improving outcomes.

Keywords:
Fracture classificationFragility fractureOsteoporosisPainPelvic stability

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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.