COMPLEX PELVIC FRACTURES IN ELDERLY DIABETICS: SURGICAL TREATMENT AND CLINICAL COMPLICATIONS

Abstract

Introduction: Complex pelvic fractures in elderly diabetics represent a significant challenge in modern medicine, especially due to bone fragility and complications associated with diabetes mellitus. The combination of these conditions makes treatment and recovery particularly difficult, since diabetes negatively affects the healing process and increases the risk of postoperative complications. Scientific studies show that the prevalence of these fractures has increased, highlighting the need for a therapeutic approach that considers both orthopedic aspects and the metabolic and cardiovascular comorbidities frequently present in these patients. Rehabilitation and long-term follow-up are essential to ensure not only functional recovery but also the quality of life of patients, who often face significant limitations after surgical treatment. Objective: The objective of this systematic literature review was to analyze and synthesize the available evidence on surgical treatment and clinical complications associated with complex pelvic fractures in elderly diabetics, focusing on therapeutic approaches that promote better functional recovery and on identifying factors that negatively influence clinical outcomes. Methodology: The methodology of this review was structured based on the PRISMA checklist, using the PubMed, Scielo, and Web of Science databases to select articles published in the last 10 years. Five main descriptors were used: "pelvic fractures," "diabetes mellitus," "elderly," "orthopedic surgery," and "postoperative complications." Inclusion criteria included studies involving elderly patients with diabetes, addressing complex pelvic fractures, and reporting postsurgical outcomes. Articles that were not available in full text, studies focusing exclusively on nonpelvic fractures, and research conducted in nondiabetic patients were excluded. Results: The results of the review highlighted the importance of strict glycemic control in the postoperative period as a crucial factor for recovery, significantly reducing the rates of infectious complications. Early rehabilitation was also identified as essential for the prevention of new fractures and for the recovery of mobility. In addition, the management of associated comorbidities, such as hypertension, was shown to be vital for the success of long-term treatment. Conclusion: The conclusion of this systematic review indicated that the treatment of pelvic fractures in elderly diabetics requires a comprehensive multidisciplinary approach, which integrates the management of comorbidities, the optimization of glycemic control and the implementation of rehabilitation strategies adapted to the specific needs of each patient. This approach, by considering all risk factors and promoting a holistic recovery, was shown to be essential to improve clinical outcomes and quality of life in these patients.