[Influence of routine CT examination on fracture classification and therapy for pelvic ring fractures in patients aged over 65 years old]. / Einfluss der Standard-Computertomografie hinsichtlich Frakturklassifikation und Therapie von Beckenringfrakturen bei Patienten über dem 65. Lebensjahr.
Z Orthop Unfall
; 150(5): 477-83, 2012 Oct.
Article
em De
| MEDLINE
| ID: mdl-23076745
ABSTRACT
BACKGROUND:
The incidence of pelvic ring fractures in elderly patients increases continuously. Several studies showed that the complexity of injury is often underestimated and a fracture of the posterior pelvic ring not visible with conventional X-rays. The aim of this study was to determine the influence of routine CT on incidence, classification of and therapy for pelvic ring fractures in patients aged over 65 years. PATIENTS ANDMETHODS:
Between 2004 and 2010, 310 elderly patients with a pelvic ring fracture were admitted to a German university level 1 trauma centre. Patients of group 1 (2004-2006) were examined with CT only if a pelvic ring fracture was diagnosed by X-ray and pain in the posterior pelvic ring persisted so that mobilisation was impossible. In group 2 (2007-2010) CT was used for routine examination. Demographic data, injury mechanism and severity (ISS) were documented as well as time and type of diagnostic procedure. Also fracture classification (AO), time and type of treatment were investigated in correlation with total hospital stay.RESULTS:
252 (82â%) patients were female, the median age was 81 years (65-100 years). 228 (74â%) had a low energy trauma, 41 (13â%) a traffic accident and 12 (4â%) had fallen from heights over 3 m. Only in 29 (9â%) cases was no trauma evident. 35 (11â%) patients were injured with an ISS over 16 and classified as polytrauma. The mean ISS was 26.8 ± 11.7. In group 2 the incidence of type A fractures decreased from 64â% to 36â%, whereas the incidence of type B fractures increased from 25â% to 49â% as did isolated sacrum fractures from 1â% to 6â%. Also the indication for operative stabilisation changed in type B fractures from 33â% to 40â% and in isolated sacrum fractures to 71â%. Total hospital stay was between eight and ten days in non-operative and between 20 and 22 days in operative treatment.CONCLUSION:
A low energy trauma is the major cause of injury for patients of an age over 65 years with a pelvic ring fracture. With the routine CT examination type B fractures and isolated sacrum fractures are seen more often than expected and resulting in a change of treatment procedures.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ossos Pélvicos
/
Ferimentos não Penetrantes
/
Tomografia Computadorizada por Raios X
/
Fraturas Ósseas
Tipo de estudo:
Etiology_studies
/
Prevalence_studies
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
País/Região como assunto:
Europa
Idioma:
De
Revista:
Z Orthop Unfall
Assunto da revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Ano de publicação:
2012
Tipo de documento:
Article