Assessment of Treatment Variability for Pelvic Ring Fragility Fractures
University of Maryland, Baltimore
Summary
Fragility fractures of the pelvic ring are a common injury associated with poor patient outcomes and high healthcare costs. Management of these injuries is evolving with increasing frequency of operative stabilization of the pelvic ring, despite a lack of evidence supporting operative versus nonoperative treatment. This multicenter prospective cohort study will evaluate 120 patients to determine the feasibility of a randomized controlled trial comparing operative and nonoperative treatment, by evaluating patient willingness to enroll in a trial, surgeon willingness to randomize their patients' treatment, and the completeness of data collection.
Description
Fragility fractures of the pelvic ring are a common injury that is increasing in incidence with an aging population. These injuries are associated with high healthcare costs and poor patient outcomes, including decline in ambulatory function, decreased independence, and a one-year mortality of 11-27%. Historically, older adults with fragility fractures of the pelvis received nonoperative treatment with supportive care because operative management was deemed too invasive for this patient population. However, the development of percutaneous and less invasive surgical techniques has led to an inc…
Eligibility
- Age range
- 60+ years
- Sex
- All
- Healthy volunteers
- No
The inclusion criteria are: 1. Patient 60 years of age or older. 2. Low energy injury mechanism. 3. LC1 pelvis fracture (AO/OTA 61B1.1,61B2.1, or 61B3.2) confirmed with antero-posterior, inlet, and outlet pelvis radiographs, computed tomography, or magnetic resonance imaging. 4. Fracture displacement of \<10 mm of the posterior pelvic ring on computed tomography of the pelvis. 5. Injury occurred within 21 days of screening. The exclusion criteria are: 1. Patient did not ambulate prior to injury. 2. Severely frail patients (Clinical Frailty Scale ≥7). 3. Patient has another condition, injury…
Interventions
- ProcedureSurgical stabilization of pelvic fracture
Surgical stabilization of pelvic fracture through placement of orthopaedic hardware.
- OtherClosed treatment of pelvic fracture
Pelvic fracture that is treated without surgery and assessed over time through interval radiographs until fracture is healed.
Location
- University of Maryland, BaltimoreBaltimore, Maryland