The best evidence summary for the preventive management of recurrent fractures in elderly patients with pelvic fragility fractures

ZHAO Xu; BAO Lipei; WANG Ansu; ZHOU Yufeng; HE Jianping; DENG Songyue

doi:10.12104/j.issn.1674-4748.2025.05.004

Abstract：Objective:To search,sort out,evaluate and summarize the relevant evidence of the prevention and management of refracture in elderly patients with pelvic fragility fracture,so as to provide evidence-based evidence for clinical practice.Methods:Guided by the"6S"model,electronic searches were systematically conducted across domestic and international guidelines,authoritative websites,and Chinese/English databases to identify literature on re-fracture prevention and management strategies for pelvic fragility fractures in older adults.The search encompassed clinical decision-making tools,guidelines,expert consensuses,evidence summaries,and systematic reviews,supplemented by additional searches for high-quality original studies.The search time was from the establishment of the database to July 31 2024.Literature screening and quality evaluation were conducted independently by two researchers,and literature evidence meeting the quality criteria was extracted.Results:A total of 13 literatures were included,comprising 7 guidelines,5 expert consensus and 1 systematic review.29 pieces of evidence were summarized from 7 dimensions:multidisciplinary team management,fracture risk assessment and screening,fall prevention management,nutrition intervention,exercise management,pharmacological management and health education.Conclusion:This paper summarizes the best evidence of prevention and management of refracture of elderly pelvic fragility fractures,and suggests that clinicians should develop individualized and localized refracture prevention and management programs according to the medical situation and the patients'specific conditions.