{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:33:19Z","timestamp":1789806799411,"version":"4.0.1"},"reference-count":49,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Pelvic insufficiency fractures (PIF) are typical in geriatric populations with reduced bone quality, most commonly in elderly postmenopausal women. These fractures are usually caused by low-energy forces over the bones during ordinary life and cause disabling pain. Treatment options range from conservative to operative. The aim of this study is to assess the outcomes of treatments for pelvic insufficiency fractures, determining optimal approaches between surgical intervention and conservative management. Methods: This literature review systematically examines articles focusing on patients with PIF, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and using PubMed, Medline, and the Cochrane Library database. We took into account only full-text articles in indexed journals with available English abstracts, considering data about patient demographics, surgery, and outcomes. Results: After screening 128 articles, this study reviewed 20 manuscripts involving 1499 patients, mostly elderly females and focusing on sacrum fractures. Common treatments included conservative methods and sacroplasty, with a few complications reported. Osteoporosis was the prevalent comorbidity, and the survival rate post-treatment was high at 92.3%. Mobility outcomes varied, with some patients experiencing significant autonomy loss. The average follow-up period was over 17 months. Conclusions: This study found a cautious approach to surgery (timing of three weeks), which is reserved only for specific patterns, and it leads to increased autonomy and a lower risk of mortality. Due to the lack of pre- and postoperative scores as well as conflicting results, it is imperative to undertake further studies and research to be able to compare the alternative treatments efficiently.<\/jats:p>","DOI":"10.3390\/jcm13113176","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T03:38:30Z","timestamp":1716953910000},"page":"3176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluating Treatment Outcomes for Pelvic Insufficiency Fractures: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3003-2391","authenticated-orcid":false,"given":"Giulia Maria","family":"Sassara","sequence":"first","affiliation":[{"name":"Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-6785","authenticated-orcid":false,"given":"Amarildo","family":"Smakaj","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Biomedicine and Prevention, \u201cTor Vergata\u201d University of Rome, 00133 Rome, Italy"},{"name":"Department of Orthopaedics and Traumatology, \u201cPoliclinico Tor Vergata\u201d Foundation, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"De Mauro","sequence":"additional","affiliation":[{"name":"Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Public Health, Orthopedic Unit, Federico II University, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Righini","sequence":"additional","affiliation":[{"name":"Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Arnone","sequence":"additional","affiliation":[{"name":"Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rovere","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Orthopaedics and Traumatology, \u201cPoliclinico Tor Vergata\u201d Foundation, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"El Ezzo","sequence":"additional","affiliation":[{"name":"Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Farsetti","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, \u201cPoliclinico Tor Vergata\u201d Foundation, 00133 Rome, Italy"},{"name":"Department of Clinical Sciences and Translational Medicine, \u201cTor Vergata\u201d University of Rome, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0330-2189","authenticated-orcid":false,"given":"Umberto","family":"Tarantino","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, \u201cPoliclinico Tor Vergata\u201d Foundation, 00133 Rome, Italy"},{"name":"Department of Clinical Sciences and Translational Medicine, \u201cTor Vergata\u201d University of Rome, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-8155","authenticated-orcid":false,"given":"Francesco","family":"Liuzza","sequence":"additional","affiliation":[{"name":"Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Department of Geriatrics and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Department of Biomedicine and Prevention, \u201cTor Vergata\u201d University of Rome, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/j.injury.2013.06.023","article-title":"Comprehensive classification of fragility fractures of the pelvic ring: Recommendations for surgical treatment","volume":"44","author":"Rommens","year":"2013","journal-title":"Injury"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.archger.2016.06.020","article-title":"Risk factors for pelvic insufficiency fractures and outcome after conservative therapy","volume":"67","author":"Maier","year":"2016","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1007\/s00113-020-00932-1","article-title":"Clinical outcome and revenue situation after conservative, interventional and surgical\/osteosynthetic treatment of sacral insufficiency fractures","volume":"124","author":"Andresen","year":"2021","journal-title":"Unfallchirurg"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.injury.2007.01.021","article-title":"Treatment options of pelvic and acetabular fractures in patients with osteoporotic bone","volume":"38","author":"Vanderschot","year":"2007","journal-title":"Injury"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Andresen, J.R., Radmer, S., Andresen, R., Prokop, A., Schr\u00f6der, G., Nissen, U., and Schober, H.-C. (2022). Comparative outcome of different treatment options for fragility fractures of the sacrum. BMC Musculoskelet. 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PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"103495","DOI":"10.1016\/j.otsr.2022.103495","article-title":"Is the conservative treatment of sacral insufficiency fractures still up to date? Retrospective clinical observational study in 46 patients","volume":"109","author":"Schramm","year":"2023","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"120","DOI":"10.5371\/hp.2017.29.2.120","article-title":"Pelvic Insufficiency Fracture in Severe Osteoporosis Patient","volume":"29","author":"Na","year":"2017","journal-title":"Hip Pelvis"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"J\u00e4ckle, K., Meier, M.P., Seitz, M.T., H\u00f6ller, S., Spering, C., Acharya, M.R., and Lehmann, W. (2021). A retrospective study about functional outcome and quality of life after surgical fixation of insufficiency pelvic ring injuries. BMC Musculoskelet. 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Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3176\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:49:53Z","timestamp":1760107793000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,29]]},"references-count":49,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13113176"],"URL":"https:\/\/doi.org\/10.3390\/jcm13113176","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,29]]}}}