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Fragility Fractures of the Pelvis.

Fragility fractures of the pelvic ring (FFP) show an increasing frequency. Trauma mechanism, fracture morphology and degree of instability are different from those in high-energy pelvic ring lesions. Little is known about the optimal treatment strategy. A new comprehensive classification system with four categories of increasing instability is presented. It is connected with recommendations for type and invasiveness of treatment. FFP Type I are anterior instabilities only and can be treated conservatively. FFP Type II are non-displaced posterior lesions which can be treated conservatively or with percutaneous fixation. FFP Type III lesions are unilateral displaced posterior lesions which require open reduction and internal fixation. FFP Type IV lesions are bilateral displaced posterior lesions and require bilateral dorsal fixation. The clinical pathway and different surgical techniques of stabilization are presented.