Trujillo-González R, Ramos-Guerrero A

Language: Spanish
References: 26
Page: 159-165
PDF size: 237.68 Kb.

ABSTRACT

Introduction: as the population pyramid gets inverted, more active and longer lives are lived, geriatric patients with high energy trauma (HET) become more frequent; requiring more resources, getting worse results with more perioperative complications, coupled with a fragile state of health and osteopenia, make these fractures difficult to manage. With the hypothesis that the incidence of pelvic and acetabular fractures in the elderly due to HET is higher than that reported in the world literature, the research question was generated: What is the incidence of pelvic and acetabular fractures in the elderly due to HET, in a 5-year period? Material and methods: with the authorization of the Ethics Committee, an observational study of a retrospective cohort was carried out, using medical records, identifying the incidence of these fractures, surgically treated in our institution Clínica Las Vegas, Medellin, Colombia, a level III hospital, from July 1, 2016 to June 30, 2021. Results: a cumulative incidence of 1.95 new cases per 100,000 person-years was calculated, a prevalence of 13.8%; resulting in a higher incidence and prevalence, confirming our hypothesis. Conclusion: treatment should be aimed at improving quality of life with stable fixation, identification and treatment of associated injuries, minimizing the risk of mechanical complications and prioritizing the reinforcement of preventive measures, also in the improvement of male role behavior, whom, as it seems, will keep carrying out risky activities despite their age.

REFERENCES

1. Ministerio de Salud y Protección Social de Colombia. Envejecimiento y vejez. Minsalud.gov.co, 2020. Disponible en: www.minsalud.gov.co/proteccionsocial/promocion-social/Paginas/envejecimiento-vejez.aspx

2. United Nations, Department of Economic and Social Affairs, Population Division. World population ageing 2019: highlights (ST/ESA/SER.A/430). 2019 [Access 14/01/2021]. Available in: www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

3. Katz M, Okuma MAA, Santos ALG, Guglielmetti CLB, Sakaki MH, Zumiotti AV. Epidemiologia das lesoes traumáticas de alta energia em idosos. Acta Ortop Bras. 2008; 16(5): 279-83.

4. Gomes de Souza JA, Iglesias AC. Trauma no idoso. Rev Assoc Med Bras. 200; 48(1): 79-86.

5. Hill BW, Switzer JA, Cole PA. Management of high-energy acetabular fractures in the elderly individuals: a current review. Geriatr Orthop Surg Rehabil. 2012; 3(3): 95-106.

6. Prieto-Alhambra D, Avilés FF, Judge A, Van Staa T, Nogués X, Arden NK, et al. Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality. Osteoporos Int. 2012; 23(12): 2797-803.

7. Helfet DL, Borrelli J Jr, DiPasquale T, Sanders R. Stabilization of acetabular fractures in elderly patients. J Bone Joint Surg Am. 1992; 74(5): 753-65.

8. Firoozabadi R, Cross WW, Krieg JC, Routt MLC. Acetabular fractures in the senior population- epidemiology, mortality and treatments. Arch Bone Jt Surg. 2017; 5(2):96-102.

9. Hessmann MH, Nijs S, Rommens PM. Acetabulumfrakturen im alter. Der Unfallchirurg. 2002; 105(10): 893-900.

10. Anglen JO, Burd TA, Hendricks KJ, Harrison P. The "Gull Sign": a harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma. 2003; 17(9): 625-34.

11. Mann SM, Banaszek D, Lajkosz K, Brogly SB, Stanojev SM, Evans C, et al. High-energy trauma patients with pelvic fractures: Management trends in Ontario, Canada. Injury. 2018; 49(10): 1830-40.

12. Keller JM, Sciadini MF, Sinclair E, O'Toole RV. Geriatric trauma: demographics, injuries, and mortality. J Orthop Trauma. 2012; 26(9): e161-5.

13. Alton TB, Firoozabadi R. Management of pelvic ring fractures in the geriatric patient. Curr Geri Rep. 2014; 3: 101-108.

14. Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM. Pelvic fracture in geriatric patients: a distinct clinical entity. J Trauma. 2002; 53(1): 15-20.

15. Scalea TM, Simon HM, Duncan AO, Atweh NA, Sclafani SJ, Phillips TF, et al. Geriatric blunt multiple trauma: improved survival with early invasive monitoring. J Trauma. 1990; 30(2): 129-34; discussion 134-6.

16. Magnussen RA, Tressler MA, Obremskey WT, Kregor PJ. Predicting blood loss in isolated pelvic and acetabular high-energy trauma. J Orthop Trauma. 2007; 21(9): 603-7.

17. Grossman MD, Miller D, Scaff DW, Arcona S. When is an elder old? Effect of preexisting conditions on mortality in geriatric trauma. J Trauma. 2002; 52(2): 242-6.

18. Hesp WL, Goris RJ. Conservative treatment of fractures of the acetabulum. Results after longtime follow-up. Acta Chir Belg. 1988; 88(1): 27-32.

19. Chong KH, DeCoster T, Osler T, Robinson B. Pelvic fractures and mortality. Iowa Orthop J. 1997; 17: 110-4.

20. Ooi CK, Goh HK, Tay SY, Phua DH. Patients with pelvic fracture: what factors are associated with mortality? Int J Emerg Med. 2010; 3(4): 299-304.

21. Gustavo Parreira J, Coimbra R, Rasslan S, Oliveira A, Fregoneze M, Mercadante M. The role of associated injuries on outcome of blunt trauma patients sustaining pelvic fractures. Injury. 2000; 31(9): 677-82.

22. Zelle BA, Cole PA. Open reduction and internal fixation of complex geriatric acetabular fracture. Oper Tech Orthop. 2011; 21(4): 286-92.

23. Pagenkopf E, Grose A, Partal G, Helfet DL. Acetabular fractures in the elderly: treatment recommendations. HSS J. 2006; 2(2): 161-71.

24. Miller AN, Prasarn ML, Lorich DG, Helfet DL. The radiological evaluation of acetabular fractures in the elderly. J Bone Joint Surg Br. 2010; 92(4): 560-4.

25. Secretaría Seccional de Salud y Protección Social de Antioquia G de A. Población [Internet]. www.dssa.gov.co. [Acceso 27 de abril de 2022]. Disponible en: https://www.dssa.gov.co/index.php/component/k2/item/635-poblacion

26. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and dislocation classification compendium-2018. J Orthop Trauma. 2018; 32 Suppl 1: S1-S170. doi: 10.1097/BOT.0000000000001063.

EVIDENCE LEVEL

IV