抄録
Recently the incidence of high-energy trauma in the elderly due to traffic accidents seems to have been increasing. In our hospital, we often treat cases of trauma to the limbs and pelvic area caused by traffic accidents. Among these cases, we selected 18 cases of fracture in individuals aged 65 years old or more, involving the scapular arch, spine, pelvis, and lower limbs that had been sustained in car or motorcycle accidents. We examined the ages of the patients, the areas of injury, the Injury Severity Scores(ISSs), the methods of orthopedic treatment, and the clinical results.
The average patient age was 73.9 years. The area of injury was the lower leg in most cases, followed in order by the pelvis and the femur. Amalgamation damage, head injury accounted for the majority.
The average ISS was 19.5. The ISS was obviously high in fatal cases, and in cases having amalgamated head injury. All 3 inoperable cases that were ultimately fatal involved head injury. In patients who survived, early operative intervention achieved excellent results.
Pelvic fractures occurred at high frequency, affecting 10 cases. As the reported mortality rate of pelvic fractures is high in the elderly, in our hospital we actively perform transcatheter arterial embolization (TAE) and bone fixation at as early a stage as possible.
In elderly patients with high-energy trauma, the presence of head injury seems to be associated with an unfavorable outcome. For many cases of pelvic fracture, it is important to actively perform TAE and early fracture stabilization.
