• Arch Orthop Trauma Surg · Aug 2021

    Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility.

    • Peter Obid, Andreas Conta, Philipp Drees, Peer Joechel, Thomas Niemeyer, and Norbert Schütz.
    • Spine and Scoliosis Center, Asklepios Paulinen Klinik, Geisenheimer Strasse 10, 65197, Wiesbaden, Germany. p.obid@gmx.de.
    • Arch Orthop Trauma Surg. 2021 Aug 1; 141 (8): 1319-1324.

    IntroductionIn 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.MethodsRetrospective 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.ResultsMean 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.ConclusionsMinimally 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.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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