1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Wollmerstädt J, Pieroh P, Schneider I, et al. Mortality, complications and long-term functional outcome
in elderly patients with fragility fractures of the acetabulum. BMC Geriatr. 2020;20(1):66. doi:10.1186/
s12877-020-1471-x.
Ueda Y, Inui T, Kurata Y, Tsuji H, Saito J, Shitan Y. Prolonged pain in patients with fragility fractures of
the pelvis may be due to fracture progression. Eur J Trauma Emerg Surg. 2021;47(2):507–513. doi:10.1007/
s00068-019-01150-0.
Mendel T, Ullrich BW, Hofmann GO, et al. Progdressive instability of bilateral sacral fragility fractures in
osteoporotic bone: a retrospective analysis of X-ray, CT, and MRI datasets from 78 cases. Eur J Trauma
Emerg Surg. 2021;47(1):11–19. doi:10.1007/s00068-020-01480-4.
Rommens PM, Hofmann A. Focus on fragility fractures of the pelvis. Eur J Trauma Emerg Surg.
2021;47(1):1–2. doi:10.1007/s00068-020-01550-7.
Osterhoff G, Noser J, Held U, Werner CML, Pape HC, Dietrich M. Early operative versus non-operative
treatment of fragility fractures of the pelvis – a propensity matched multicenter study. J Orthop Trauma.
2019;33(11):e410-e415. doi:10.1097/BOT.0000000000001584.
Rommens PM, Arand C, Hopf JC, Mehling I, Dietz SO, Wagner D. Progress of instability in fragility fractures of the pelvis: an observational study. Injury. 2019;50(11):1966–1973. doi:10.1016/j.injury.2019.08.038.
Buller LT, Best MJ, Quinnan SM. A nationwide analysis of pelvic ring fractures: Incidence and
trends in treatment, length of stay, and mortality. Geriatr Orthop Surg Rehabil. 2016;7(1):9–17.
doi:10.1177/2151458515616250.
Clement ND, Court-Brown CM. Elderly pelvic fractures: the incidence is increasing and patient demographics can be used to predict the outcome. Eur J Orthop Surg Traumatol. 2014;24(8):1431–1437. doi:10.1007/
s00590-014-1439-7.
Cauley JA. Public health impact of osteoporosis. J Gerontol A Biol Sci Med Sci. 2013;68(10):1243–1251.
doi:10.1093/gerona/glt093.
Rommens PM, Ossendorf C, Pairon P, Dietz S-O, Wagner D, Hofmann A. Clinical pathways for fragility
fractures of the pelvic ring: personal experience and review of the literature. J Orthop Sci. 2015;20(1):1–11.
doi:10.1007/s00776-014-0653-9.
Rommens PM, Hofmann A. Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury. 2013;44(12):1733–1744. doi: 10.1016/j.injury.2013.06.023.
Rommens PM, Wagner D, Hofmann A. Do we need a separate classification for fragility fractures of the
pelvis? J Orthop Trauma. 2019;33 Suppl 2:S55-S60. doi:10.1097/BOT.0000000000001402.
Rommens PM, Wagner D, Hofmann A. Fragility fractures of the pelvis. JBJS Rev. 2017;5(3):e3. doi:10.2106/
JBJS.RVW.16.00057.
Hotta K, Kobayashi T. Functional treatment strategy for fragility fractures of the pelvis in geriatric patients.
Eur J Trauma Emerg Surg. 2021;47(1):21–27. doi:10.1007/s00068-020-01484-0.
Yoshida M, Tajima K, Saito Y, Sato K, Uenishi N, Iwata M. Mobility and mortality of 340 patients with
fragility fracture of the pelvis. Eur J Trauma Emerg Surg. 2021;47(1):29–36. doi:10.1007/s00068-020-014813.
Noser J, Dietrich M, Tiziani S, Werner CML, Pape HC, Osterhoff G. Mid-term follow-up after surgical
treatment of fragility fractures of the pelvis. Injury. 2018;49(11):2032–2035. doi:10.1016/j.injury.2018.09.017.
Wilson DGG, Kelly J, Rickman M. Operative management of fragility fractures of the pelvis – a systematic
Nagoya J. Med. Sci. 85. 35–49, 2023
47
doi:10.18999/nagjms.85.1.35
Takaomi Kobayashi et al
review. BMC Musculoskelet Disord. 2021;22(1):717. doi:10.1186/s12891-021-04579-w.
18 Banierink H, Ten Duis K, Prijs J, et al. What is the long-term clinical outcome after fragility fractures of
the pelvis? - a CT-based cross-sectional study. Injury. 2022;53(2):506–513.doi:10.1016/j.injury.2021.09.056.
19 Wagner D, Kisilak M, Porcheron G, et al. Trans-sacral bar osteosynthesis provides low mortality and high
mobility in patients with fragility fractures of the pelvis. Sci Rep. 2021;11(1):14201. doi:10.1038/s41598021-93559-0.
20 Oberkircher L, Lenz J, Bücking B, et al. Which factors influence treatment decision in fragility fractures
of the pelvis? – results of a prospective study. BMC Musculoskelet Disord. 2021;22(1):690. doi:10.1186/
s12891-021-04573-2.
21 Gericke L, Fritz A, Osterhoff G, Josten C, Pieroh P, Höch A. Percutaneous operative treatment of fragility
fractures of the pelvis may not increase the general rate of complications compared to non-operative
treatment. Eur J Trauma Emerg Surg. 2022;48(5):3729–3735. doi:10.1007/s00068-021-01660-w.
22 Rommens PM, Boudissa M, Krämer S, Kisilak M, Hofmann A, Wagner D. Operative treatment of fragility fractures of the pelvis is connected with lower mortality. A single institution experience. PLoS One.
2021;16(7):e0253408. doi:10.1371/journal.pone.0253408.
23 Saito Y, Tokutake K, Takegami Y, Yoshida M, Omichi T, Imagama S. Does surgical treatment for unstable
fragility fracture of the pelvis promote early mobilization and improve survival rate and postoperative clinical
function? Eur J Trauma Emerg Surg. 2022;48(5):3747–3756. doi:10.1007/s00068-021-01729-6.
24 Nuber S, Ritter B, Fenwick A, et al. Midterm follow-up of elderly patients with fragility fractures of the
pelvis: a prospective cohort-study comparing operative and non-operative treatment according to a therapeutic
algorithm. Injury. 2022;53(2):496–505.doi:10.1016/j.injury.2021.09.044.
25 Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis
protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi:10.1186/2046-4053-4-1.
26 Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting
systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71.
27 Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–605. doi:10.1007/s10654-010-9491-z.
28 Graul I, Marintschev I, Hackenbroch C, Palm HG, Friemert B, Lang P. Modified therapy concepts for
fragility fractures of the pelvis after additional MRI. PLoS One. 2020;15(10):e0238773. doi:10.1371/journal.
pone.0238773.
29 Wagner D, Kamer L, Sawaguchi T, Richards RG, Noser H, Rommens PM. Sacral bone mass distribution
assessed by averaged three-dimensional CT models: Implications for pathogenesis and treatment of fragility
fractures of the sacrum. J Bone Joint Surg Am. 2016;98(7):584–590. doi:10.2106/JBJS.15.00726.
30 Wagner D, Hofmann A, Kamer L, et al. Fragility fractures of the sacrum occur in elderly patients with
severe loss of sacral bone mass. Arch Orthop Trauma Surg. 2018;138(7):971–977. doi:10.1007/s00402-0182938-5.
31 Schönenberg D, Guggenberger R, Frey D, Pape HC, Simmen HP, Osterhoff G. CT-based evaluation of
volumetric bone density in fragility fractures of the pelvis-a matched case-control analysis. Osteoporos Int.
2018;29(2):459–465. doi:10.1007/s00198-017-4307-6.
32 Bovbjerg P, Høgh D, Froberg L, Schmal H, Kassem M. Effect of PTH treatment on bone healing in insufficiency fractures of the pelvis: a systematic review. EFORT Open Rev. 2021;6(1):9–14. doi:10.1302/20585241.6.200029.
33 Rommens PM, Arand C, Hofmann A, Wagner D. When and how to operate fragility fractures of the pelvis?
Indian J Orthop. 2019;53(1):128–137. doi:10.4103/ortho.IJOrtho_631_17.
34 Na WC, Lee SH, Jung S, Jang HW, Jo S. Pelvic insufficiency fracture in severe osteoporosis patient. Hip
Pelvis. 2017;29(2):120–126. doi:10.5371/hp.2017.29.2.120.
35 Kasukawa Y, Miyakoshi N, Ebina T, et al. Enhanced bone healing and decreased pain in sacral insufficiency
fractures after teriparatide treatment: retrospective clinical-based observational study. Clin Cases Miner Bone
Metab. 2017;14(2):140–145. doi:10.11138/ccmbm/2017.14.1.140.
36 Smith CT, Barton DW, Piple AS, Carmouche JJ. Pelvic fragility fractures: an opportunity to improve the
undertreatment of osteoporosis. J Bone Joint Surg Am. 2021;103(3):213–218. doi:10.2106/JBJS.20.00738.
37 Rommens PM, Hofmann A, Kraemer S, Kisilak M, Boudissa M, Wagner D. Operative treatment of fragility
fractures of the pelvis: a critical analysis of 140 patients. Eur J Trauma Emerg Surg. 2022;48(4):2881–2896.
doi:10.1007/s00068-021-01799-6.
38 Santolini E, Kanakaris NK, Giannoudis PV. Sacral fractures: Issues, challenges, solutions. EFORT Open
Rev. 2020;5(5):299–311. doi:10.1302/2058-5241.5.190064.
39 Schmerwitz IU, Jungebluth P, Lehmann W, Hockertz TJ. Minimally invasive posterior locked compression
Nagoya J. Med. Sci. 85. 35–49, 2023
48
doi:10.18999/nagjms.85.1.35
Fragility fracture of the pelvis
plate osteosynthesis shows excellent results in elderly patients with fragility fractures of the pelvis. Eur J
Trauma Emerg Surg. 2021;47(1):37–45. doi:10.1007/s00068-020-01498-8.
40 Arduini M, Saturnino L, Piperno A, Iundusi R, Tarantino U. Fragility fractures of the pelvis: treatment and
preliminary results. Aging Clin Exp Res. 2015;27 Suppl 1:S61-S67. doi:10.1007/s40520-015-0430-4.
41 Rommens PM, Wagner D, Hofmann A. Minimal invasive surgical treatment of fragility fractures of the
pelvis. Chirurgia (Bucur). 2017;112(5):524–537. doi:10.21614/chirurgia.112.5.524.
42 Nakayama Y, Suzuki T, Honda A, et al. Interdigitating percutaneous screw fixation for Rommens
type IIIa fragility fractures of the pelvis: technical notes and preliminary clinical results. Int Orthop.
2020;44(11):2431–2436. doi:10.1007/s00264-020-04664-0.
43 Walker JB, Mitchell SM, Karr SD, Lowe JA, Jones CB. Percutaneous transiliac-transsacral screw fixation
of sacral fragility fractures improves pain, ambulation, and rate of disposition to home. J Orthop Trauma.
2018;32(9):452–456. doi:10.1097/BOT.0000000000001243.
44 Kim WY, Lee SW, Kim KW, Kwon SY, Choi YH. Minimally invasive surgical treatment using ‘iliac pillar’
screw for isolated iliac wing fractures in geriatric patients: a new challenge. Eur J Trauma Emerg Surg.
2019;45(2):213–219. doi:10.1007/s00068-018-1046-0.
45 Zderic I, Wagner D, Schopper C, et al. Screw-in-screw fixation of fragility sacrum fractures provides high
stability without loosening-biomechanical evaluation of a new concept. J Orthop Res. 2021;39(4):761–770.
doi:10.1002/jor.24895.
46 König A, Oberkircher L, Beeres FJP, Babst R, Ruchholtz S, Link BC. Cement augmentation of sacroiliac
screws in fragility fractures of the pelvic ring-A synopsis and systematic review of the current literature.
Injury. 2019;50(8):1411–1417. doi:10.1016/j.injury.2019.06.025.
47 Hopf JC, Krieglstein CF, Müller LP, Koslowsky TC. Percutaneous iliosacral screw fixation after osteoporotic
posterior ring fractures of the pelvis reduces pain significantly in elderly patients. Injury. 2015;46(8):1631–
1636. doi:10.1016/j.injury.2015.04.036.
48 Schmitz P, Baumann F, Grechenig S, Gaensslen A, Nerlich M, Müller MB. The cement-augmented transiliacal internal fixator (caTIFI): an innovative surgical technique for stabilization of fragility fractures of the
pelvis. Injury. 2015;46 Suppl 4:S114-S120. doi:10.1016/S0020-1383(15)30029-2.
49 Yoshimura S, Inoue M, Nakajima T, et al. Minimally invasive “crab-shaped fixation” for treating patients
with fragility fractures of the pelvis. Spine Surg Relat Res. 2021;5(6):425–430. doi:10.22603/ssrr.2020-0213.
50 Okazaki S, Shirahama M, Hashida R, et al. Iliac intramedullary stabilization for Type IIIA fragility fractures
of the pelvis. Sci Rep. 2020;10(1):20380. doi:10.1038/s41598-020-77560-7.
51 Schuetze K, Eickhoff A, Dehner C, Blidon A, Gebhard F, Richter PH. Short-term outcome of fragility
fractures of the pelvis in the elderly treated with screw osteosynthesis and external fixator. Eur J Trauma
Emerg Surg. 2022;48(3):2413–2420. doi:10.1007/s00068-021-01780-3.
52 Suero EM, Greiner A, Becker CA, et al. Biomechanical stability of sacroiliac screw osteosynthesis with
and without cement augmentation. Injury. 2021;52(10):2707–2711. doi:10.1016/j.injury.2020.01.043.
53 Kang S, Chung PH, Kim JP, Kim YS, Lee HM, Eum GS. Superior gluteal artery injury during percutaneous
iliosacral screw fixation: a case report. Hip Pelvis. 2015;27(1):57–62. doi:10.5371/hp.2015.27.1.57.
54 Pascal-Moussellard H, Hirsch C, Bonaccorsi R. Osteosynthesis in sacral fracture and lumbosacral dislocation.
Orthop Traumatol Surg Res. 2016;102(1 Suppl):S45-S57. doi:10.1016/j.otsr.2015.12.002.
55 Kim JW, Oh CW, Oh JK, et al. The incidence of and factors affecting iliosacral screw loosening in pelvic
ring injury. Arch Orthop Trauma Surg. 2016;136(7):921–927. doi:10.1007/s00402-016-2471-3.
56 Eckardt H, Egger A, Hasler RM, et al. Good functional outcome in patients suffering fragility fractures of
the pelvis treated with percutaneous screw stabilization: assessment of complications and factors influencing
failure. Injury. 2017;48(12):2717–2723. doi:10.1016/j.injury.2017.11.002.
57 Herteleer M, Boudissa M, Hofmann A, Wagner D, Rommens PM. Plate fixation of the anterior pelvic
ring in patients with fragility fractures of the pelvis. Eur J Trauma Emerg Surg. 2022;48(5):3711–3719.
doi:10.1007/s00068-021-01625-z.
58 Booth A, Ingoe HMA, Northgraves M, et al. Effectiveness of surgical fixation for lateral compression type
one (LC-1) fragility fractures of the pelvis: a systematic review. BMJ Open. 2019;9(5):e024737. doi:10.1136/
bmjopen-2018-024737.
59 Young JW, Burgess AR, Brumback RJ, Poka A. Pelvic fractures: Value of plain radiography in early
assessment and management. Radiology. 1986;160(2):445–451. doi:10.1148/radiology.160.2.3726125.
60 Rommens PM, Hofmann A. The FFP-classification: From eminence to evidence. Injury. 2021;S00201383(21)00790-7. doi:10.1016/j.injury.2021.09.016.
References End
Nagoya J. Med. Sci. 85. 35–49, 2023
49
doi:10.18999/nagjms.85.1.35
...