Discussion
thrombosis, primarily urinary tract infections, pneumonia, pelvic fractures, blood loss, fracture, prerenal renal failure, organ dysfunction, implant failure
THROMBOSIS, PNEUMONIA, URINARY TRACT INFECTIONS, BLOOD LOSS, COMPLICATION, SECONDARY, COMPLICATIONS
The perioperative outcome of geriatric patients with FFP is primarily limited by the underlying individual comorbidities. This can only be positively influenced to a limited extent during acute inpatient treatment. Therefore, surgical treatment should aim at mobilizing patients as quickly as possible to prevent secondary complications such as pneumonia, thrombosis, and urinary tract infections. This includes adequate fracture stabilisation for sufficient relief of symptoms. At the same time, surgical invasiveness and perioperative blood loss should be kept to a minimum to prevent haemorrhagic circulatory depression with resulting organ dysfunction such as prerenal renal failure [Regarding minimally invasive stabilization of pelvic fractures, Riesner et al. described an external blood loss of only 70 mL on average in a study of 23 triangular stabilizations [The duration of surgery is considered a trigger for the incidence of secondary complications, especially in elderly patients. Consequently, surgery should be kept as short as possible. Vanderschot et al. reported a mean operation time of 60 min for the implantation of a single transsacral rod in 19 patients [The length of inpatient stay correlates significantly with the loss of independence, the degree of care dependency, and the rate of institutionalized accommodation [Intraoperative and secondary complications can significantly affect the perioperative outcome. Gericke et al. recorded a general complication rate of 28.4% in 74 minimally invasive treated FFP patients, primarily urinary tract infections. The reported rate of surgical-side complications was 9.5%, and the leading cause was implant failure in 6.8% of cases [The 1-year mortality rate of geriatric patients with FFP is reported in the literature to be between 10 and 27% [Only a few studies describe the course of treatment immediately following the acute inpatient stay. Kanakaris et al. differentiated FFP patients into the following four categories: unaided community ambulatory, aided community ambulatory, household ambulatory, and non-functional ambulatory. In 56.6% cases, patients were able to regain their pre-injury status after one year, while 32% lost one and 11.3% lost two status levels [The prospective design of our comparative cohort study is a major strength. In addition, the groups compared are very homogeneous both in terms of epidemiological data and regarding the consideration of one specific fracture type. However, our study also has some limitations. The choice of osteosynthesis procedure was based on the individual anatomy of the sacrum and the described fracture types [