J Korean Fract Soc.  2017 Oct;30(4):186-191. 10.12671/jkfs.2017.30.4.186.

Clinical Features and Outcomes of Pelvic Insufficiency Fractures

• Seo YM
• Kim YC
• Kim JW

• KMID: 2424130
• DOI: http://doi.org/10.12671/jkfs.2017.30.4.186

Abstract

PURPOSE
The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population.
MATERIALS AND METHODS
At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture.
RESULTS
A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability.
CONCLUSION
We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

Keyword

Pelvis; Pelvis fracture; Insufficiency fractures; Osteoporosis

MeSH Terms

Aged
Bone Density
Bone Remodeling
Diagnosis
Female
Fractures, Stress*
Gait
Humans
Osteoporosis
Pelvic Bones
Pelvis
Retrospective Studies
Walking

Figure

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  Fig. 1 (A) Initial pelvis Anteroposterior image of an 86-year-old female showing a non-displaced fracture at the right inferior ramus (arrow). (B) Outlet view showing right inferior ramus fracture (arrow). (C) Inlet view showing no definite posterior ring disruption. (D) Computed tomography images revealing both sacral alar fractures.

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