• Ludwig Oberkircher, Steffen Ruchholtz, Pol Maria Rommens, Alexander Hofmann, Benjamin Bücking, and Antonio Krüger.
• Center for Orthopedics and Trauma Surgery, Philipps University Marburg; Center for Orthopedics and Trauma Surgery, Johannes Gutenberg University Mainz; Department of Orthopedics and Trauma Surgery, Westpfalz-Klinikum GmbH, Kaiserslautern.
• Dtsch Arztebl Int. 2018 Feb 2; 115 (5): 708070-80.

BackgroundThe estimated incidence of osteoporotic pelvic fractures among persons over age 60 in Germany is 224 per 100 000 persons per year, and rising. A number of surgical treatment options are available, but clinical long-term data are lacking.MethodsThis review is based on pertinent publications and guidelines retrieved by a selective literature search, and on the authors' clinical experience.ResultsPatients often report one or more relatively trivial traumatic incidents leading up to the fracture. They complain of pain in the hip, groin, or lower lumbar region, or of low back pain and sciatica. A new classification scheme entitled Fragility Fractures of the Pelvis (FFP) takes the morphology of the fracture into account and can be used as an aid to therapeutic decision-making (evidence level IV). The goal of treatment is early mobilization with adequate pain relief. Isolated anterior pelvic ring fractures (FFP I) and nondisplaced posterior pelvic ring fractures (FFP II) are usually stable and can be treated conservatively. Type III and IV injuries are unstable and should generally be treated surgically.ConclusionRetrospective analyses have shown that osteoporotic pelvic fractures are associated with decreased mobility and independence and with a one-year mortality ranging from 9.5% to 27%. Prospective therapeutic trials are urgently needed.

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