Journal ArticleDOI
Comprehensive classification of fragility fractures of the pelvic ring: Recommendations for surgical treatment.
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TLDR
A novel classification system for fragility fractures of the pelvis based on morphological criteria and the degree of instability is proposed, which gives hints for treatment strategies, which may vary between minimally invasive techniques and complex surgical reconstructions.Abstract:
Due to the increasing life expectancy, orthopaedic surgeons are more and more often confronted with fragility fractures of the pelvis (FFPs). These kinds of fractures are the result of a low-energy impact or they may even occur spontaneously in patients with severe osteoporosis. Due to some distinct differences, the established classifications for pelvic ring lesions in younger adults do not fully reflect the clinical and morphological criteria of FFPs. Most FFPs are minimally displaced and do not require surgical therapy. However, in some patients, an insidious progress of bone damage leads to increasing displacement, nonunion and persisting instability. Therefore, new concepts for surgical treatment have to be developed to address the functional needs of the elderly patients. Based on an analysis of 245 consecutive patients with FFPs, we propose a novel classification system for this condition. This classification is based on morphological criteria and it corresponds with the degree of instability. Also in the elderly, these criteria are the most important for the decision on the type of treatment as well as type and extent of surgery. The estimation of the degree of instability is based on radiological and clinical findings. The classification gives also hints for treatment strategies, which may vary between minimally invasive techniques and complex surgical reconstructions.read more
Citations
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Journal ArticleDOI
Complications of pelvic radiation in patients treated for gynecologic malignancies
Akila N. Viswanathan,Larissa J. Lee,Jairam R. Eswara,Neil S. Horowitz,Panagiotis A. Konstantinopoulos,Kristina Mirabeau-Beale,Brent S. Rose,Arvind von Keudell,Jennifer Y. Wo +8 more
TL;DR: Current understanding of the incidence of various morbidities in patients treated with current radiation techniques for gynecologic malignancies, the impact of chemotherapy and surgery, treatment options for those effects, and future areas of research are highlighted.
Journal ArticleDOI
Fragility fractures of the sacrum: how to identify and when to treat surgically?
TL;DR: Surgical options include minimal invasive sacro-iliac screws, trans-sacral bar osteosynthesis, open reduction and internal fixation, or spinopelvic stabilization; however, an operative approach often is indicated to accelerate the patient’s mobility.
Journal ArticleDOI
Fragility Fractures of the Pelvis
TL;DR: A new comprehensive classification system with four categories of increasing instability of the pelvic ring shows an increasing frequency and is connected with recommendations for type and invasiveness of treatment.
Journal ArticleDOI
Clinical pathways for fragility fractures of the pelvic ring: personal experience and review of the literature
TL;DR: A literature review of treatment alternatives is presented and a new comprehensive classification considers both fracture morphology and degree of instability of the pelvic ring, which provides recommendations for type and invasiveness of treatment.
Journal ArticleDOI
Risk factors for pelvic insufficiency fractures and outcome after conservative therapy
Gerrit Steffen Maier,Kristina Kolbow,Djordje Lazovic,Konstantin Horas,Klaus Edgar Roth,Jörn Bengt Seeger,Uwe Maus +6 more
TL;DR: Osteoporosis was found to be significantly associated with pelvic insufficiency fractures, as was hypertension, diabetes,abetes, vitamin D deficiency, hypocalcaemia, and nicotine abuse, all of which can benefit easy preventive measures.
References
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Olof Johnell,John A. Kanis +1 more
TL;DR: It is concluded that osteoporotic fractures are a significant cause of morbidity and mortality, particularly in the developed countries.
Journal ArticleDOI
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Journal ArticleDOI
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TL;DR: In this article, a new classification was made of these injuries based on roentgenographic appearance and anatomical lesions in 300 displaced fractures and fracture-dislocations of the proximal end of the humerus.
Journal ArticleDOI
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TL;DR: In this paper, a study of 117 three-part and four-part displaced proximal humeral fractures, followed for from one to sixteen years, is presented, and the results were rated by a numerical system.
Journal ArticleDOI
Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations.
TL;DR: In this study the mechanism of fracture was determined by fracturing, the pathologic anatomy was ascertained by dissection, the genetic roent genologic diagnosis was established by roentgen examination and the genetic reduction technic of the fractures was found by reduction maneuvers.