老年脆性骨盆骨折临床诊疗指南

标题: 老年脆性骨盆骨折临床诊疗指南
title: Clinical guideline for diagnosis and treatment of fragility fractures of the pelvis
版本: 原创版
version: Original
分类: 标准指南
classification: Standard guideline
领域: 诊疗
field: Diagnosis and Treatment
国家和地区: 中国
Country and region: China
指南使用者: 为我国二、三级医疗机构的专科医务人员,包括骨科医生、老年病科医生、风湿科医生、疼痛科医生、康复科医生及相应专科护士,以及保健机构的医务人员
Guide users: It is a specialist medical personnel of secondary and tertiary medical institutions in China, including orthopedic doctors, geriatricians, rheumatologists, pain doctors, rehabilitation doctors and corresponding specialist nurses, as well as medical personnel of health care institutions
证据分级方法: 本指南采用的文献等级评定标准参照推荐意见分级的评估、制订及评价(Grading of Recommendations Assessment,Development and Evaluation,GRADE )分级体系工作组和其他工作组的相关方法评估研究证据体的质量。结合研究设计和其他证据特征综合判定研究的证据级别(表1)和推荐强度(表2)。通过三轮Delphi法确立推荐意见方向和强度。
Evidence grading method: The literature grading criteria used in this guide assess the quality of research evidence body against the relevant methods of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Grading System Working Group and other working groups. The level of evidence and recommended intensity of the study were determined by combining the study design and other evidentiary features (Table 1). Establish the direction and strength of recommendations through the three-round Delphi method.
制定单位: 解放军总医院骨科学部
Formulating unit: The Faculty of Orthopaedics of Chinese PLA General Hospital
注册时间: 2022-05-12
Registration time:
注册编号: IPGRP-2022CN266
Registration number:
指南制订的目的: 随着人口寿命的快速增长和低的生育率,世界人口正以前所未有的速度老龄化,老年脆性骨折发生率也逐年增多。文献报道过去20年来,由于全社会的关注与多部指南、共识的推广应用,美国老年髋部骨折下降了25.7%,而老年脆性骨盆骨折(Fragility Fractures of the Pelvis, FFP)反而增加了24%,呈现逐年增多的趋势。欧洲也有类似的文献报道,老年脆性骨盆骨折年增长率约是人口增长率的1.5倍。目前,保守治疗仍是主流思想,但Loggers等回顾性研究117例老年脆性骨盆骨折,49%的患者失去了独立活动能力,34%的患者完全丧失生活自理能力,40%的患者没有完全恢复到伤前状态,1年死亡率为23%,与老年髋部骨折一样,具有高致残率和死亡率。二十一世纪,我国迅速进入人口老龄化社会,老年脆性骨盆骨折将成为一个亟待解决和关注的临床问题。
Purpose of the guideline: With the rapid growth of life expectancy and low fertility rates, the world's population is aging at an unprecedented rate, and the incidence of fragile fractures in old age is increasing year by year . In the past 20 years, due to the attention of the whole society and the promotion and application of multiple guidelines and consensus, the elderly hip fractures in the United States have decreased by 25.7%, while the Fragility Fractures of the Pelvis (FFP) in the elderly have increased by 24%, showing a trend of increasing year by year. Similar literature has been reported in Europe that the annual growth rate of fragile pelvic fractures in the elderly is about 1.5 times the population growth rate. At present, conservative treatment is still the mainstream thinking, but Loggers et al. retrospectively studied 117 cases of elderly fragile pelvic fractures, 49% of patients lost the ability to move independently, 34% of patients completely lost the ability to live independently, 40% of patients did not fully recover to pre-injury state, 1-year mortality rate was 23%, and as with elderly hip fractures, it had a high disability rate and mortality rate. In the twenty-first century, China has rapidly entered an aging population society, and elderly fragile pelvic fractures will become a clinical problem that needs to be solved and concerned urgently.