Broken pelvis mortality for elderly patient

My 95yr Great aunt just broke her arm and two bones in her pelvis. My sister said this can be fatal. Is that true? I thought she would just take a bit longer to heal. :confused:

IANAD, but my understanding is that the broken pelvis will keep her from being mobile, or even sitting comfortably. Immobility in the elderly can lead to bedsores, pneumonia, and other problems. Also, there’s the question of what caused the injury. A fall, for example, can be the result of other conditions such as a stroke.

Did she break her pelvis or did she break her hip? It’s much more common for an elderly person to break their hip, which is the upper part of the femur.

Either way, unfortunately, roughly half of seniors who break a limb are dead within a year. When you are less mobile following surgery a variety of complications such as pneumonia can occur. Also, people who fall once are likely to fall again, so re-injury is common. If someone has a dementia going under anesthesia can accelerate the dementia process rapidly. People in their 90s are less likely to be independent or to be able to do everything they were previously doing following a fall with broken bones and surgery. It’s not to say that your aunt won’t make a full recovery, people certainly do, but your sister is correct that this sort of thing can be fatal. Best of luck to her.

Here is some more information from the CDC:
http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Breaking a pelvis can be fatal even in younger people, it’s pretty frickin’ serious regardless of age.

On the other hand, I know a lady who underwent a traumatic foot amputation in her late '90’s during a traffic accident and not only survived several more years but was able to adapt to a prosthesis. Not that she was getting around that great prior to the accident but did make as full a recovery as possible for her age. While any bone break is more serious in someone in that age it is possible for them to heal up. A lot depends on the general health of the elderly person at the time of an accident. Being a mentally alert, active and able 95 year old is considerably different than being a frail and debilitated 95 year old.

There are a couple of things that can go wrong that are more common in elderly people. Sadly, yes, some of these are fatal. If you want to know more, let us know, but if you don’t want to worry about details, that’s okay, too. That’s a lot to break at once, so it may indicate some other underlying illness that may also be fatal. Any broken bone in someone this old is concerning, and to have three fractures at once is even more so.

I’m sorry she’s going through this. Hang in there.

Thanks for all your answers. I’ve been reading other boards and finding “YES” its very serious. My sweet little aunty makes it to 95yrs and has to deal with this shite!

From anything I’ve ever heard, breaking the pelvis or hip can end up being fatal in the elderly. On the other hand, there are interesting success stories such as Walter Breuning, who, upon his death in 2011 at the age of 114, had the 4th longest lifespan of any man that could be documented.

At the age of 108, Breuning broke his hip but made a recovery. He walked successfully with a walker after that.

At that age, just about anything can have fatal consequences. My mother was about the same age when she fell in the bathroom. There was a cut on her head, a bruised shoulder, and a broken collarbone. Totally non-life-threatening, but in less than 3 days she was dead.

In this case, like in so many of the previous posts, my WAG is that most elderly people are already at a disadvantage healthwise, and then when something like this happens, the body devotes so many resources to damage control, that there’s nothing to spare for life support.

(Any medical professionals want to weigh in on that? I plead guilty to over-simplifying, but am I perhaps accurate anyway?)

A lot probably depends on how much physical therapy they do. If they are resistant to the therapy, either because it hurts or they’re stubborn, then they could lose a lot of mobility. They would also be at risk of strokes from clots that break off.

If your aunt can take an active role in her recovery, she’ll be much better off.

Simplified, yes, but not overly so. Decreased mobility, a slower immune system, multiple medications, changes in balance and reaction time…there are a lot of issues that tend to come with age, even if they’re not, strictly speaking, caused by age.

In my mother’s case it was the fact that she was already on so many meds that an adequate pain killer couldn’t be administered. So her upper-body pain prevented her from swallowing, coughing or clearing her throat adequately . . . which meant mucous and saliva were trickling down into her lungs. And any attempt to remove it lowered her blood pressure. Eventually her heart function was compromised.

Sometimes it’s just a weird combination of factors that collapse like dominoes.

Oh, it absolutely is, I was just saying that a hip fracture is much more common.

OP, how was your aunt’s health otherwise?

I should mention that I’m a speech therapist in geriatric rehabilitation; I’ve known a lot of little old ladies with broken bones in my life.

Another contributing factor is that in the elderly (especially women) broken hips are often due to osteoporosis, which makes a full recovery from a fracture problematic.

I don’t think anyone has mentioned that whereas broken hips are treated (and “cured”) surgically, there is no surgical treatment for pelvic fractures (or, at it’s least seldom performed). One of the consequences of this is that pelvic fractures can hurt and immobilize an individual for a long time, longer than with a fractured (and then fixed) hip.

The longer someone, especially an elderly person, has pain and immobility (or reduced mobility), the more likely they are to develop any of the complications that people have mentioned already. To summarize:

Immobility (or significantly reduced mobility) promotes blood clots, pneumonia (and partial collapse of the lung, called atelectasis), urinary tract infection, constipation, “bed sores”, and "deconditioning (basically an accelerated form of muscle atrophy and loss of fitness). Deconditioning occurs rapidly in the elderly, within 48 hours, and can lead to a vicious circle with deconditioning leading to less mobility etc.

And, of course, simply being in a health care institution, by statistics if not neglect, may lead to medical misadventure (e.g. getting your neighbour’s medication). Likewise, such places may be crawling with virulent bacteria. And, the act of hospitalization itself can cause a previously well and lucid older individual to develop delirium. Delirium leads to all sorts of undesirable effects.

All the medications used to relieve pain and thus promote mobility (and maintain conditioning) have side effects which can be profound and all too common in the elderly. Narcotics, even weak ones like codeine lead to constipation. And even though constipation might be a minor problem, more of an annoyance, for a 30-year-old, it can turn into a life-threatening, situation for a frail 90-year-old. Narcotics also lead to delirium which leads to its own problems including more falls, permanent cognitive impairment, and much more, including death. Drugs like Motrin (NSAIDs) are particularly toxic to the elderly, leading to kidney problems, heart failure, and internal bleeding. Yet, if you don’t treat the pain, the person won’t want to move, or at least will participate less in their physiotherapy and quit sooner.

Bottom line, as said above my several people, fractured pelvises can kill. Indeed, anything that requires an older, especially a frail elderly person to be hospitalized, can start a chain of events that too often leads to loss of independence, cognitive decline, and even death.

I didn’t know that. I’m used to dogs and cats getting pelvic repairs and so thought people got them, too. Thinking about it, I guess it’s a much more difficult surgical approach in people. Good/interesting to know.

OP, I hope your auntie manages to get better.

Just to be clear, I’m talking primarily about the relatively common pubic rami fracture that occur in the elderly. Management may be different in more youthful patients or when there is associated soft tissue damage (e.g. bladder, urethra) such as may occur in, say, a serious MVA.

I hope your Aunt recovers :heart:. My 88 year old Mum broke her pelvis last week. Shec lives in her own home and was fine til my brother went back to live. He said he eas looking after her. She was admitted to hospital, described by Amulance Drivers. Malnourished, dehydrated and filthy - so much for brother!!
She is feeble and tiny and cant walk on pelvis. She has been saying weird things when i speak to her on phone, as i live on other side of Australia. She also is freezing cold and getti g worse. Its definately not cold there. How do you think she will fare…will she be abke to go home. So many question. Thank you all.

I suppose it would be in poor taste to use the word “zombie” at this point, but the OP posted over two years ago, and hasn’t been heard from in nearly as long.