Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility
Introduction In 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...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2021-08, Vol.141 (8), p.1319-1324 |
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| creator | Obid, Peter Conta, Andreas Drees, Philipp Joechel, Peer Niemeyer, Thomas Schütz, Norbert |
| description | Introduction
In 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.
Methods
Retrospective 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.
Results
Mean 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
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| doi_str_mv | 10.1007/s00402-020-03597-y |
| format | Article |
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In 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.
Methods
Retrospective 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.
Results
Mean 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.
Conclusions
Minimally 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.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03597-y</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Geriatrics ; Medicine ; Medicine & Public Health ; Minimally invasive surgery ; Orthopedics ; Surgery ; Surgical outcomes ; Trauma Surgery</subject><ispartof>Archives of orthopaedic and trauma surgery, 2021-08, Vol.141 (8), p.1319-1324</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-bfd480c1542c5025e5af18332ea8331a7438b3e0061b14297657cce4e3b21d5c3</citedby><cites>FETCH-LOGICAL-c352t-bfd480c1542c5025e5af18332ea8331a7438b3e0061b14297657cce4e3b21d5c3</cites><orcidid>0000-0003-4923-1064</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03597-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03597-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Obid, Peter</creatorcontrib><creatorcontrib>Conta, Andreas</creatorcontrib><creatorcontrib>Drees, Philipp</creatorcontrib><creatorcontrib>Joechel, Peer</creatorcontrib><creatorcontrib>Niemeyer, Thomas</creatorcontrib><creatorcontrib>Schütz, Norbert</creatorcontrib><title>Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
In 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.
Methods
Retrospective 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.
Results
Mean 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.
Conclusions
Minimally 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.</description><subject>Geriatrics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally invasive surgery</subject><subject>Orthopedics</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Trauma Surgery</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kc1qFUEQhRsx4DX6Aq4a3LgZU_03P-4kGBOIuNF109O3JnTomb52970wPojPm0pGCLhw09UU5ztV1GHsnYCPAqC7KAAaZAMSGlBm6Jr1BdsJrXSjBtG-ZDsYVNv0YMQr9rqUewAh-wF27M-3sITZxbjysJxcCSfk8TiP6YDxFDwv1Y0hht-uhrTwNPHifHaRT9ndUb-ujz9fjxkLGfAwz-lJj3t-hzm4msnkQDQutXziE9KIcQPdsufoMk3OSAYLr4lvdF3fsLPJxYJv_9Zz9vPqy4_L6-b2-9eby8-3jVdG1mac9roHL4yW3oA0aNwkeqUkOnqF67TqR4UArRiFlkPXms571KhGKfbGq3P2YfM95PTriKXaORSPMboF07FYqXXbdkJpRdL3_0jvE21N21lpjGoFubekkpvK51RKxskeMt03r1aAfYzKblFZiso-RWVXgtQGFRIvdLdn6_9QD6APmso</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Obid, Peter</creator><creator>Conta, Andreas</creator><creator>Drees, Philipp</creator><creator>Joechel, Peer</creator><creator>Niemeyer, Thomas</creator><creator>Schütz, Norbert</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4923-1064</orcidid></search><sort><creationdate>20210801</creationdate><title>Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility</title><author>Obid, Peter ; Conta, Andreas ; Drees, Philipp ; Joechel, Peer ; Niemeyer, Thomas ; Schütz, Norbert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-bfd480c1542c5025e5af18332ea8331a7438b3e0061b14297657cce4e3b21d5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Geriatrics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally invasive surgery</topic><topic>Orthopedics</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Trauma Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Obid, Peter</creatorcontrib><creatorcontrib>Conta, Andreas</creatorcontrib><creatorcontrib>Drees, Philipp</creatorcontrib><creatorcontrib>Joechel, Peer</creatorcontrib><creatorcontrib>Niemeyer, Thomas</creatorcontrib><creatorcontrib>Schütz, Norbert</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Obid, Peter</au><au>Conta, Andreas</au><au>Drees, Philipp</au><au>Joechel, Peer</au><au>Niemeyer, Thomas</au><au>Schütz, Norbert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><date>2021-08-01</date><risdate>2021</risdate><volume>141</volume><issue>8</issue><spage>1319</spage><epage>1324</epage><pages>1319-1324</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
In 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.
Methods
Retrospective 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.
Results
Mean 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.
Conclusions
Minimally 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00402-020-03597-y</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-4923-1064</orcidid></addata></record> |
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| subjects | Geriatrics Medicine Medicine & Public Health Minimally invasive surgery Orthopedics Surgery Surgical outcomes Trauma Surgery |
| title | Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility |
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