Peter Obid1, Andreas Conta2, Philipp Drees3, Peer Joechel4, Thomas Niemeyer4, Norbert Schütz5. 1. Spine and Scoliosis Center, Asklepios Paulinen Klinik, Geisenheimer Strasse 10, 65197, Wiesbaden, Germany. p.obid@gmx.de. 2. Institute of Physics, Johannes Gutenberg Universität, Mainz, Germany. 3. Department of Orthopaedics and Traumatology, Johannes Gutenberg Universität, Mainz, Germany. 4. Spine and Scoliosis Center, Asklepios Paulinen Klinik, Geisenheimer Strasse 10, 65197, Wiesbaden, Germany. 5. Department of Geriatric Medicine, Asklepios Paulinen Klinik, Wiesbaden, Germany.
Abstract
INTRODUCTION: In an aging society, the incidence of sacral fragility fractures is increasing and diagnosis is often delayed. Immobilization has devastating consequences especially in elderly patients. Short-term mobilization of these patients is crucial. The aim of this study is to evaluate the early return to mobility of immobilized geriatric patients with sacral fragility fractures treated with minimally invasive lumbopelvic stabilization. METHODS: Retrospective analysis of thirteen consecutive patients (13 females) which could not be mobilized with conservative treatment, and thus were treated with minimally invasive lumbopelvic stabilization. Pain intensity measurement on an 11-point Numeric Rating Scale (NRS), Tinetti Mobility Test (TMT), and Timed Up and Go Test (TUGT) were performed preoperatively and 4 weeks postoperatively. Surgical and medical complications were analyzed. RESULTS: Mean age at surgery was 83.92 ± 6.27 years and mean ASA score was 2.77 ± 0.42. NRS improved from a mean of 7.18 ± 0.98 preoperatively to a mean of 2.45 ± 0.93 4 weeks postoperatively (Ρ < 0.001). TMT score improved from a mean of 4.15 ± 3.67 preoperatively to a mean of 16.39 ± 4.61 4 weeks postoperatively (Ρ < 0.001). Due to immobilization, patients were not able finish TUGT preoperatively. Four weeks postoperatively TUGT reached a mean of 31.1 ± 11.08 s. There were two surgical complications (one wound healing disorder, one rod dislocation) in two patients that required revision surgery. Two patients developed pneumonia postoperatively. CONCLUSIONS: Minimally invasive lumbopelvic stabilization of sacral fragility fractures is feasible in geriatric patients. Early mobilization of these patients is possible after surgery. The rate of complications is acceptable.
INTRODUCTION: In an aging society, the incidence of sacral fragility fractures is increasing and diagnosis is often delayed. Immobilization has devastating consequences especially in elderly patients. Short-term mobilization of these patients is crucial. The aim of this study is to evaluate the early return to mobility of immobilized geriatric patients with sacral fragility fractures treated with minimally invasive lumbopelvic stabilization. METHODS: Retrospective analysis of thirteen consecutive patients (13 females) which could not be mobilized with conservative treatment, and thus were treated with minimally invasive lumbopelvic stabilization. Pain intensity measurement on an 11-point Numeric Rating Scale (NRS), Tinetti Mobility Test (TMT), and Timed Up and Go Test (TUGT) were performed preoperatively and 4 weeks postoperatively. Surgical and medical complications were analyzed. RESULTS: Mean age at surgery was 83.92 ± 6.27 years and mean ASA score was 2.77 ± 0.42. NRS improved from a mean of 7.18 ± 0.98 preoperatively to a mean of 2.45 ± 0.93 4 weeks postoperatively (Ρ < 0.001). TMT score improved from a mean of 4.15 ± 3.67 preoperatively to a mean of 16.39 ± 4.61 4 weeks postoperatively (Ρ < 0.001). Due to immobilization, patients were not able finish TUGT preoperatively. Four weeks postoperatively TUGT reached a mean of 31.1 ± 11.08 s. There were two surgical complications (one wound healing disorder, one rod dislocation) in two patients that required revision surgery. Two patients developed pneumonia postoperatively. CONCLUSIONS: Minimally invasive lumbopelvic stabilization of sacral fragility fractures is feasible in geriatric patients. Early mobilization of these patients is possible after surgery. The rate of complications is acceptable.
Authors: Thomas A Schildhauer; Carlo Bellabarba; Sean E Nork; David P Barei; Milton L Chip Routt; Jens R Chapman Journal: J Orthop Trauma Date: 2006-07 Impact factor: 2.512
Authors: Dietmar Krappinger; Verena Kaser; Christian Kammerlander; Carl Neuerburg; Anke Merkel; Richard A Lindtner Journal: Injury Date: 2018-11-15 Impact factor: 2.586