Occult posterior pelvic ring fractures in elderly patients with osteoporotic pubic rami fractures

J Orthop Surg (Hong Kong). 2010 Aug;18(2):153-7. doi: 10.1177/230949901001800205.

Abstract

Purpose: To evaluate postoperative walking status of elderly patients with osteoporotic pubic rami fractures with or without posterior pelvic ring fractures.

Methods: 33 women and 4 men aged 66 to 95 (mean, 85) years presented with osteoporotic pubic rami fractures after a fall. 22 (59%) of the patients had additional posterior pelvic ring fractures (9 had lateral compression type-II fractures involving the ilium and 13 had lateral compression type-I fractures involving the sacroalar region). Seven of the 9 patients with lateral compression type-II fractures underwent open reduction and internal fixation using plates and/ or screws. The remaining 30 patients were treated conservatively.

Results: Postoperative walking status was similar in elderly patients with osteoporotic pubic rami fractures with or without posterior pelvic ring fractures.

Conclusion: Posterior pelvic ring fractures are easily missed in elderly patients with pubic rami fractures. Routine computed tomography of the pelvis is useful in making the diagnosis.

Publication types

  • Comparative Study

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / etiology*
  • Fractures, Bone / surgery
  • Humans
  • Male
  • Osteoporosis / complications*
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / surgery
  • Prognosis
  • Pubic Bone / diagnostic imaging
  • Pubic Bone / injuries*
  • Radionuclide Imaging
  • Retrospective Studies
  • Tomography, X-Ray Computed