Artikel
Surgical treatment of pelvic ring fractures in the elderly now and then – a pelvic registry study
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Autoren
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Mika Rollmann
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Germany
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Steven Becker
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Germany
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Jörg Holstein
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Germany
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Tim Pohlemann
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Germany
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Michael Menger
- Institut für Klinisch-Experimentelle Chirurgie, Universitätsklinikum des Saarlandes, Homburg, Germany
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Tina Histing
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Germany
| Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: With the demographic change the treatment of elderly patients has become a major issue for health systems worldwide.
The aim of this study was to analyze the change in the rate of surgical treatment of pelvic ring fractures in patients with an age of 60 years and older over a 22-year period depending on fracture type, age and sex.
Methods: Data of 5,665 patients with an age of 60 years and older, who were treated for pelvic ring fractures from 1991-2013 in one of 31 hospitals participating in the German Trauma Pelvic Registry were included. The registry is divided into four time periods t1=1991-1993, t2=1997-2000, t3=2001-2008 and t4=2009-2013. Data had been collected prospectively and was analyzed retrospectively, stratified for age and sex of the patients as well as type of fracture and mode of therapy (surgical vs. conservative).
Results and Conclusion: There was a significant increase (p<0.05) in the overall rate of surgical treatment. While the rate of surgical treatment increased in type A (t1: 0.8% vs t4: 2.8%; p<0.05) and, in particular, in type C fractures (t1: 42.4% vs t4: 74.5%; p< 0.05), the frequency of surgical treatment of type B fractures remained unchanged (26.8% on average). Nonetheless, during all time periods patients with an age >70 years were significantly less frequently surgically treated compared 60-70 year-olds. During t1 the rate of surgical treatment of all types of fractures was significantly higher (p< 0.05) in male compared to female patients. While this difference persisted for the frequency of surgical treatment of type A and type B fractures, the frequency of surgical treatment of type C fractures approximated in males and females (t4: female = 71.9% vs. male = 79.2%).
The present data indicate that the rate of surgical treatment of pelvic ring fractures in elderly patients has significantly increased over the 22-year period. Nonetheless, older patients ( >70 years) as well as female patients are still less frequently surgically treated.
