Issue: 2018, Vol. 23, No. 3

Makurin M. Yu., Vereschagin N. A., Valuyev A. N., Vereschagina E. N., Garkaviy N. G.

SURGICAL TREATMENT FOR PELVIS BONES FRACTURES IN ELDERLY PATIENTS (OVER 60 YEARS)

Keywords

fractures of pelvis bones, microinvasive fixation, early activation

Abstarct

Actuality - rapid aging of population resulted in increased incidence of osteoporosis-associated fractures. Low energetic lesions of pelvis ring in elderly patients led to mobility deprivation and even death including complications in traditional conservative treatment. Objective - to demonstrate the possibilities of early activation in elderly patients with pelvis injuries in improvement of direct and remote results of their treatment. Material and methods. 55 patients (aged 60-89 years) with pelvic ring injuries after low energetic trauma were treated. In accordance with the objective of the study two groups of patients were formed. The comparison group included 29 patients which undergone traditional treatment in 2002-2008 (long term strict bed rest, skeletal traction, hammock). The main group included 26 patients which undergone active tactics of treatment in 2009-2017 with minimally invasive surgical techniques for early activation. Mortality rate, number of complications, functional outcome of the treatment which was estimated in 12 months after injury were taken into consideration. Results. Mortality rate in the comparison group exceeded this parameter in the main group by 11,4%, complications (bed sore, pneumonia, urinary tract infections) were also more often recorded in patients from the comparison group (78,9%); infectious complications in the zone of operative wound were more often registered in the main group (25% patients). Good results (pelvis anatomy restoration, absence of painful sensations, activity maintenance on the level before trauma) were more often obtained in the main group (73,3%) than in the comparison group (54,5%); there were no unsatisfactory remote results in the main group. Conclusions. It was demonstrated that the application of early activation, active rehabilitation, early microinvasive osteorraphy resulted in the improvement of treatment findings, in significant decrease of complication number, in the diminishment of death rate of patients.

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