Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    

Users Online: 205 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Year : 2019  |  Volume : 53  |  Issue : 1  |  Page : 128-137

When and how to operate fragility fractures of the pelvis?

1 Department of Orthopaedics and Traumatology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
2 Department of Traumatology and Orthopaedics, Westpfalz-Clinics, Kaiserslautern, Germany

Correspondence Address:
Prof. Pol Maria Rommens
Department of Orthopaedics and Traumatology, University Medical Center, Johannes Gutenberg-University, Mainz
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ortho.IJOrtho_631_17

Rights and Permissions

Fragility fractures of the pelvis (FFP) are an entity with an increasing frequency. The characteristics of these fractures are different from pelvic ring fractures in younger adults. There is a low energy instead of a high energy trauma mechanism. Due to a specific and consistent decrease of bone mineral density, typical fractures in the anterior and posterior pelvic ring occur. Bilateral sacral ala fractures are frequent. A new classification system distinguishes between four categories with increasing loss of stability. The subtypes represent different localizations of fractures. The primary goal of treatment is restoring mobility and independency. Depending on the amount of instability, conservative or surgical treatment is recommended. The operative technique should be as less invasive as possible. When the broken posterior pelvic ring is fixed operatively, a surgical fixation of the anterior pelvic ring should be considered as well. FFP Type I can be treated conservatively. In many cases, FFP Type II can also be treated conservatively. When conservative treatment fails, percutaneous fixation is performed. FFP Type III and FFP Type IV are treated operatively. The choice of the operation technique is depending on the localization of the fracture. Iliosacral screw osteosynthesis, transsacral bar osteosynthesis, transiliac internal fixation, and iliolumbar fixation are alternatives for stabilization of the posterior pelvic ring. Plate osteosynthesis, retrograde transpubic screw, and anterior internal fixation are alternatives for stabilization of the anterior pelvic ring. Postoperatively, early mobilization, with weight bearing as tolerated, is started. Simultaneously, bone metabolism is also analyzed and its defects compensated. Medical comorbidities should be identified and treated with the help of a multidisciplinary team.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded21    
    Comments [Add]    

Recommend this journal