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HOME > J Musculoskelet Trauma > Volume 30(4); 2017 > Article
Original Article
Clinical Features and Outcomes of Pelvic Insufficiency Fractures
Yong Min Seo, M.D.orcid, Young Chang Kim, M.D., Ph.D.orcid, Ji Wan Kim, M.D., Ph.D.orcid
Journal of the Korean Fracture Society 2017;30(4):186-191.
DOI: https://doi.org/10.12671/jkfs.2017.30.4.186
Published online: October 25, 2017

Department of Orthopaedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Correspondence to: Ji Wan Kim, M.D., Ph.D. Department of Orthopaedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeundaero, Haeundae-gu, Busan 48108, Korea. Tel: +82-51-797-0668, Fax: +82-51-797-0669, bakpaker@hanmail.net
• Received: September 20, 2017   • Revised: September 22, 2017   • Accepted: September 22, 2017

Copyright © 2017 The Korean Fracture Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population.
  • Materials and Methods
    At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture.
  • Results
    A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability.
  • Conclusion
    We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.
  • Key words: Pelvis, Pelvis fracture, Insufficiency fractures, Osteoporosis
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Fig. 1

(A) Initial pelvis Anteroposterior image of an 86-year-old female showing a non-displaced fracture at the right inferior ramus (arrow). (B) Outlet view showing right inferior ramus fracture (arrow). (C) Inlet view showing no definite posterior ring disruption. (D) Computed tomography images revealing both sacral alar fractures.

jkfs-30-186-g001.jpg
Table 1

AO/OTA Classification of Pelvic Fracture

jkfs-30-186-i001.jpg
AO/OTA classification Number of case (%)
A2 13 (31.0)
B2 15 (35.7)
B3 8 (19.0)
C1 4 (9.5)
C2 2 (4.8)
Total 42 (100)
Table 2

Rommens Classification of Fragility Fractures of the Pelvic Ring

jkfs-30-186-i002.jpg
Rommens classification Number of case (%)
Ia 9 (21.4)
Ib2 4 (9.5)
IIa 1 (2.4)
IIb 18 (42.9)
IIc 7 (16.7)
IIIa 2 (4.8)
IIIb 1 (2.4)
IIIc 0
IV 0
Total 42 (100)

The sum of the percentages does not equal 100% because of rounding.

Table 3

Walking Ability

jkfs-30-186-i003.jpg
Post-injury 6 months walking ability Number of case (%)
Independent walking 21 (50.0)
Walking with an assistant device 19 (45.2)
Requiring a wheelchair 2 (4.8)
Bedridden 0
Recovery rate of ambulation to pre-injury levels 41 (97.6)

Figure & Data

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        • Citation for the content below
        Clinical Features and Outcomes of Pelvic Insufficiency Fractures
        J Korean Fract Soc. 2017;30(4):186-191.   Published online October 31, 2017
        DOI: https://doi.org/10.12671/jkfs.2017.30.4.186
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      Clinical Features and Outcomes of Pelvic Insufficiency Fractures
      Image
      Fig. 1 (A) Initial pelvis Anteroposterior image of an 86-year-old female showing a non-displaced fracture at the right inferior ramus (arrow). (B) Outlet view showing right inferior ramus fracture (arrow). (C) Inlet view showing no definite posterior ring disruption. (D) Computed tomography images revealing both sacral alar fractures.

      Fig. 1

      Clinical Features and Outcomes of Pelvic Insufficiency Fractures

      AO/OTA Classification of Pelvic Fracture

      AO/OTA classification Number of case (%)
      A2 13 (31.0)
      B2 15 (35.7)
      B3 8 (19.0)
      C1 4 (9.5)
      C2 2 (4.8)
      Total 42 (100)

      Rommens Classification of Fragility Fractures of the Pelvic Ring

      Rommens classification Number of case (%)
      Ia 9 (21.4)
      Ib2 4 (9.5)
      IIa 1 (2.4)
      IIb 18 (42.9)
      IIc 7 (16.7)
      IIIa 2 (4.8)
      IIIb 1 (2.4)
      IIIc 0
      IV 0
      Total 42 (100)

      The sum of the percentages does not equal 100% because of rounding.

      Walking Ability

      Post-injury 6 months walking ability Number of case (%)
      Independent walking 21 (50.0)
      Walking with an assistant device 19 (45.2)
      Requiring a wheelchair 2 (4.8)
      Bedridden 0
      Recovery rate of ambulation to pre-injury levels 41 (97.6)
      Table 1 AO/OTA Classification of Pelvic Fracture

      Table 2 Rommens Classification of Fragility Fractures of the Pelvic Ring

      The sum of the percentages does not equal 100% because of rounding.

      Table 3 Walking Ability

      Table 1

      Table 2

      Table 3

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