pirogovestnikВестник Национального медико-хирургического центра им. Н.И. ПироговаBulletin of Pirogov National Medical & Surgical Center2072-82552782-3628Национальный медико-хирургический Центр им. Н.И. Пирогова10.25881/20728255_2025_20_3_83pirogovestnik-364Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКОНСЕРВАТИВНОЕ ЛЕЧЕНИЕ ПЕРЕЛОМОВ КОСТЕЙ ТАЗА У ПАЦИЕНТОВ СТАРШЕ 65 ЛЕТCONSERVATIVE TREATMENT OF PELVIC BONE FRACTURES IN PATIENTS OVER 65 YEARS OLDСолодЭ. И.SolodE. I.

Москва

Moscow

АлхажжА.AlhajjA.

Москва

Moscow

АбдулхабировМ. А.AbdulkhabirovM. A.

Москва

Moscow

ПапоянВ. С.PapoyanV. S.

Москва

Moscow

БекшоковК. К.BekshokovK. K.

Москва

Moscow

kazbek.bekshokov.99@mail.ruФГБОУ ВПО «Российский университет дружбы народов им. Патриса Лумумбы»; ГБУЗ «Городская клиническая больница им. А.К. Ерамишанцева»; ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова»РоссияPeoples’ Friendship University of Russia; A.K. Yeramishantsev City Clinical Hospital; N.N. Priorov National Medical Research Center of Traumatology and OrthopedicsRussian FederationФГБОУ ВПО «Российский университет дружбы народов им. Патриса Лумумбы»РоссияPeoples’ Friendship University of RussiaRussian FederationФГБОУ ВПО «Российский университет дружбы народов им. Патриса Лумумбы»; ГБУЗ «Городская клиническая больница им. А.К. Ерамишанцева»РоссияPeoples’ Friendship University of Russia; A.K. Yeramishantsev City Clinical HospitalRussian Federation2025290820252038387Copyright © Солод Э.И., Алхажж А., Абдулхабиров М.А., Папоян В.С., Бекшоков К.К., 20252025Солод Э.И., Алхажж А., Абдулхабиров М.А., Папоян В.С., Бекшоков К.К.Solod E.I., Alhajj A., Abdulkhabirov M.A., Papoyan V.S., Bekshokov K.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://submit.pirogov-vestnik.ru/jour/article/view/364

В связи с увеличением продолжительности жизни населения в мире возрастает количество людей пожилого и старческого возраста, страдающих остеопорозом. Переломы костей таза, возникающие на фоне остеопоротических изменений костей скелета, отличаются рядом характерных особенностей лечения. Если у молодых основной причины возникновения данных переломов костей таза является высокоэнергетические травмы, полученные в результате дорожно-транспортных происшествий и падений с большой высоты, то у пациентов пожилого возраста с сопутствующим остеопорозом переломы костей таза чаше возникают в результате падения с высоты собственного роста из-за хрупкости костной ткани, наличия сопутствующих заболеваний (сердечной-сосудистой системы, дыхательной системы, эндокринной системы и других) и нарушение адаптационных способностей, что затрудняет выбор метода лечения.Цель исследования: улучшение результатов лечения пациентов с переломами костей таза старше 65 лет.Задача исследования: изучение среднесрочных и отдаленных результатов консервативного лечения повреждений костей таза у пациентов старше 65 лет в зависимости от характера перелома и сопутствующих заболеваний.Материалы и методы. За период с 2021 по 2024 гг. в городской клинической больнице имени А.К. Ерамишанцева было пролечено 30 пациентов (средний возраст 72±6,21 года) старше 65 лет с переломами костей таза. Распределение переломов костей таза по классификации AO/OTA было следующим: тип A у 6 (20%) пациентов, тип B у 18 (60%), перелом вертлужной впадины у 6 (20%) пациентов.Результаты и выводы. Среднесрочные результаты лечения через 6 мес. удалось проследить по шкале Majeed у 30 (100%) пациентов (у 6 они были отличными, у 16 – хорошими, у 6 – удовлетворительными, у 2 – плохими). Оценка отдаленных результатов лечения через 12 месяцев проводилась у 24 (80%) пациентов (у 6 из них они были отличными, у 12 – хорошими, у 4 – удовлетворительными, у 2 – плохими). Через 2 года оценка проводилась у 16 (53%) пациентов (у 4 они были отличными, у 8 – хорошими, у 2 – удовлетворительными, у 2 – плохими). Прежний уровень активности восстановили 26 (86%) пациента. Летальность составила 0%. Проведенный анализ результатов лечения переломов костей таза показал, что у пожилых пациентов с коморбидным анамнезом предпочтительно придерживаться консервативной тактики лечения.

Due to the general increase in life expectancy of the population, the number of elderly and senile people suffering from osteoporosis is increasing in the world. Pelvic bone fractures that occur against the background of osteoporotic changes in the bones of the skeleton are distinguished by a number of characteristic features and are associated with a high mortality rate. If in the young population the main cause of these fractures are high-energy injuries resulting from road accidents and falls from a great height, then in elderly patients with concomitant osteoporosis, pelvic fractures can occur as a result of a fall from their own height. Fragility of bone tissue, the presence of a large number of chronic diseases and impaired adaptive capacity of the body in elderly patients complicates surgical fixation of pelvic ring fractures using various metal structures, which forces clinicians to adhere to conservative treatment tactics.Aims: to study the medium-term and long-term results of conservative treatment of pelvic bone injuries in patients over 65 years of age.Materials and methods. During the period from 2021 to 2024, a total of 30 patients (mean age 72±6.21 years) over 65 years old with pelvic bone fractures were treated at the A.K. Yeramishantsev City Clinical Hospital. The distribution of pelvic bone fractures according to the AO/OTA classification was as follows: type A in 6 (20%) patients, type B in 18 (60%), acetabular fracture in 6 (20%) patients.Results and conclusions. The mid-term treatment results after 6 months were assessed in 30 (100%) patients (in 6 they were excellent, in 16 – good, in 6 – satisfactory, in 2 – poor). The remote treatment results after 12 months were assessed in 24 (80%) patients (in 6 of them they were excellent, in 12 – good, in 4 – satisfactory, in 2 – poor). After 2 years, 16 (53%) patients were assessed (4 had excellent results, 8 had good results, 2 had satisfactory results, and 2 had poor results). 26 (86%) patients restored their previous activity level. Mortality was 0%. The analysis of pelvic fracture treatment results showed that in elderly patients with a comorbid history, it is preferable to adhere to conservative treatment tactics.

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The authors declare that there are no conflicts of interest present.