Insuffizienzfrakturen des Beckenrings

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• 作者：Dr. F.M. Stuby (1)
  A. Sch?ffler (1)
  T. Haas (1)
  B. K?nig (1)
  U. St?ckle (1)
  T. Freude (1)
  
• 关键词：Beckenringfraktur ; Osteoporose ; Insuffizienzfraktur ; Ermüdungsfraktur ; Sakroplastie ; Pelvic ring injury ; Osteoporosis ; Insufficiency fracture ; Fatigue fracture ; Sacroplasty
• 刊名：Trauma und Berufskrankheit
• 出版年：2014
• 出版时间：June 2014
• 年：2014
• 卷：16
• 期：2
• 页码：92-100
• 全文大小：
• 参考文献：1. Ahovuo JA, Kiuru MJ, Visuri T (2004) Fatigue stress fractures of the sacrum: diagnosis with MR imaging. Eur Radiol 14:500-05 CrossRef
  2. Bastian JD, Keel MJ, Heini PF et al (2012) Complications related to cement leakage in sacroplasty. Acta Orthop Belg 78:100-05
  3. Blake SP, Connors AM (2004) Sacral insufficiency fracture. Br J Radiol 77:891-96 CrossRef
  4. Bohme J, H?ch A, Boldt A, Josten C (2012) Influence of routine CT examination on fracture classification and therapy for pelvic ring fractures in patients aged over 65 years old. Z Orthop Unfall 150:477-83
  5. Bohme J, H?ch A, Gras F et al (2012) Polytrauma mit Beckenfraktur und schwerem Thoraxtrauma: Hat der Zeitpunkt der definitiven Beckenstabilisierung Einfluss auf den klinischen Verlauf? Unfallchirurg 116:923-30 CrossRef
  6. Bohme J, Hoch A, Josten C (2012) Osteoporotische Frakturen des Beckens. Chirurg 83:875-81 CrossRef
  7. Cabarrus MC, Ambekar A, Lu Y, Link TM (2008) MRI and CT of insufficiency fractures of the pelvis and the proximal femur. AJR Am J Roentgenol 191:995-001 CrossRef
  8. Culemann U, Scola A, Tosounidis G et al (2010) Versorgungskonzept der Beckenringverletzung des alten Patienten. Eine Herausforderung. Unfallchirurg 113:258-71 CrossRef
  9. Denis F, Davis S, Comfort T (1988) Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop Relat Res 227:67-1
  10. Gansslen A, Pohlemann T, Krettek C (2005) A simple supraacetabular external fixation for pelvic ring fractures. Oper Orthop Traumatol 17:296-12 CrossRef
  11. Gebhard F, Culemann U (2010) Beckenringverletzungen im Alter. Unfallchirurg 113:257 CrossRef
  12. Hauschild O, Strohm PC, Culemann U et al (2008) Mortality in patients with pelvic fractures: results from the German pelvic injury register. J Trauma 64:449-55 CrossRef
  13. Judet R, Judet J, Letournel E (1964) Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 46:1615-646
  14. Keel MJ, Benneker LM, Siebenrock KA, Bastian JD (2011) Less invasive lumbopelvic stabilization of posterior pelvic ring instability: technique and preliminary results. J Trauma 71:E62–E70 CrossRef
  15. Kobbe P, Hockertz I, Sellei RM et al (2012) Minimally invasive stabilisation of posterior pelvic-ring instabilities with a transiliac locked compression plate. Int Orthop 36:159-64 CrossRef
  16. Lange U, Muller-Ladner U, Pfeilschifter J (2011) Osteoporose: Leitliniengerechte Prophylaxe, Diagnostik und Therapie. Internist (Berl) 52:843-53
  17. Longhino V, Bonora C, Sansone V (2011) The management of sacral stress fractures: current concepts. Clin Cases Miner Bone Metab 8:19-3
  18. Mears SC, Sutter EG, Wall SJ et al (2010) Biomechanical comparison of three methods of sacral fracture fixation in osteoporotic bone. Spine (Phila Pa 1976) 35:E392–E395
  19. Mehling I, Hessmann MH, Rommens PM (2012) Stabilization of fatigue fractures of the dorsal pelvis with a trans-sacral bar. Operative technique and outcome. Injury 43:446-51 CrossRef
  20. Murthy NS (2012) Imaging of stress fractures of the spine. Radiol Clin North Am 50:799-21 CrossRef
  21. Ochs BG, Gonser C, Shiozawa T et al (2010) Computer-assisted periacetabular screw placement: comparison of different fluoroscopy-based navigation procedures with conventional technique. Injury 41:1297-305 CrossRef
  22. Pfeilschifter J, Cooper C, Watts NB et al (2012) Regional and age-related variations in the proportions of hip fractures and major fractures among postmenopausal women: the global longitudinal study of osteoporosis in women. Osteoporos Int 23:2179-188 CrossRef
  23. Pohlemann T, Gansslen A, Tscherne H (2000) Die Sakrumfraktur. Unfallchirurg 103:769-86 CrossRef
  24. Pohlemann T, Stengel D, Tosounidis G et al (2011) Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German pelvic trauma registry initiative. Injury 42:997-002 CrossRef
  25. Rommens PM, Hofmann A (2013) Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury 44:1733-744 CrossRef
  26. Rommens PM, Wagner D, Hofmann A (2012) Osteoporotic fractures of the pelvic ring. Z Orthop Unfall 150:e107–e120
  27. Rommens PM, Wagner D, Hofmann A (2012) Surgical management of osteoporotic pelvic fractures: a new challenge. Eur J Trauma Emerg Surg 38:499-09 CrossRef
  28. Shah RV (2012) Sacral kyphoplasty for the treatment of painful sacral insufficiency fractures and metastases. Spine J 12:113-20 CrossRef
  29. Smith GR, Northrop CH, Loop JW (1977) Jumpers-fractures: patterns of thoracolumbar spine injuries associated with vertical plunges. Radiology 122:657-63
  30. Starr AJ, Walter JC, Harris RW et al (2002) Percutaneous screw fixation of fractures of the iliac wing and fracture-dislocations of the sacro-iliac joint (OTA Types 61-B2.2 and 61-B2.3, or Young-Burgess ?lateral compression type II-pelvic fractures). J Orthop Trauma 16:116-23 CrossRef
  31. St?ckle U (2001) Schr?g dorsaler Beckenfixateur -Ein neues Konzept zur Beckenstabilisierung -Klinische und biomechanische Grundlagen, Entwicklung, biomechanische Testung. Habilitationsschrift, Humboldt-Universit?t Berlin, S?16, Abb.?7
  32. Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 70:1-2
  33. Tosounidis G, Wirbel R, Culemann U, Pohlemann T (2006) Fehleinsch?tzung bei vorderer Beckenringfraktur im h?heren Lebensalter. Unfallchirurg 109:678-80 CrossRef
  34. Trouvin AP, Alcaix D, Somon T, Zarnitsky C (2012) Analgesic effect of sacroplasty in osteoporotic sacral fractures: a study of six cases. Joint Bone Spine 79:500-03 CrossRef
  35. Tscherne H, Pohlemann T (1998) Unfallchirurgie. Becken und Acetabulum. Springer, Berlin Heidelberg New York, S?53-5
  36. Weber M, Hasler P, Gerber H (1999) Sacral insufficiency fractures as an unsuspected cause of low back pain. Rheumatology (Oxford) 38:90-1
  
• 作者单位：Dr. F.M. Stuby (1)
  A. Sch?ffler (1)
  T. Haas (1)
  B. K?nig (1)
  U. St?ckle (1)
  T. Freude (1)
  
  1. Abteilung für Unfall- und Wiederherstellungschirurgie, BG-Unfallklinik, Eberhard-Karls-Universit?t Tübingen, Schnarrenbergstra?e 95, 72076, Tübingen, Deutschland
  
• ISSN：1436-6282

文摘

Background The changing age distribution in our society inevitably also leads to an increase in age-specific injuries. As a result, the percentage of osteoporotic and fatigue fractures and the absolute number of insufficiency fractures of the pelvic ring are increasing. Causes of pelvic ring fractures While pelvic ring injuries in younger patients are mainly caused by high velocity accidents, the reason for pelvic fractures in elderly patients is often a trivial fall to the floor or even no impact at all. These kinds of injuries are consequently assessed as insufficiency fractures. Diagnosis and therapy Conventional x-rays of the pelvic ring are frequently not able to reveal the injury; therefore, additional diagnostic methods (e.g., CT scan or even MRI) are recommended. The established classifications for pelvic ring fractures do not sufficiently reflect the complexity of these injuries. Therapy must be chosen based on the general condition and living environment of the elderly patient. Reduced bone quality leads to problems with implants such as early loosening of conventional screws and must be considered when planning operative stabilization.