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目的:探讨老年脆性骨盆骨折(FFP)的特征，并比较保守治疗与微创手术治疗老年FFP的临床疗效。方法:回顾性分析2017年1月至2019年1月期间解放军总医院骨科医学部创伤显微外科收治的56例老年FFP患者资料。男16例，女40例，平均年龄为73.4岁（65~93岁）。美国麻醉医师协会分级：Ⅰ级12例，Ⅱ级16例，Ⅲ级20例，Ⅳ级8例。FFP分型：Ⅰ型6例，Ⅱ型10例，Ⅲ型36例，Ⅳ型4例。分析老年FFP的形态特征和损伤机制。将所有患者根据治疗方式不同分为两组：保守治疗组32例，微创手术组24例。比较两组患者治疗后1年的并发症发生率、病死率及Koval行走能力衰减率等。结果:老年FFP多为侧方挤压伤导致的耻骨联合两侧耻骨支骨折和骶骨翼压缩骨折。两组患者除FFP分型外，其他术前一般资料比较差异均无统计学意义（n P>0.05），具有可比性。保守治疗组患者治疗后1年并发症发生率为34.4%（11/32），病死率为9.4%（3/32），Koval行走能力衰减率为13.8%（4/29）；微创手术组患者分别为20.8%（5/24）、4.2%（1/24）、8.7%(2/23)，两组比较差异均无统计学意义（n P>0.05）。n 结论:老年FFP的损伤机制多为侧方挤压损伤，骨折部位多位于耻骨联合两侧耻骨支骨折和骶骨翼骨折，前后环多同时骨折。虽然保守治疗与微创手术治疗后1年患者的并发症发生率、病死率和Koval行走能力衰减率比较差异无统计学意义，但是后者的骨折类型更不稳定。“,”Objective:To investigate the characteristics of fragility fractures of pelvis(FFP) in the elderly and compare the clinical efficacy between conservative treatment and minimally invasive surgery.Methods:A retrospective study was conducted in the 56 elderly FFP patients who had been treated at Department of Orthopaedics, The General Hospital of Chinese People＇s Liberation Army from January 2017 to January 2019. They were 16 males and 40 females, with an age of 73.4 years (from 65 to 93 years). By the American Society of Anesthesiologists (ASA) classification, there were 12 cases of grade Ⅰ, 16 cases of grade Ⅱ, 20 cases of grade Ⅲ, and 8 cases of grade Ⅳ; by the FFP classification, there were 6 cases of type Ⅰ, 10 cases of type Ⅱ, 36 cases of type Ⅲ, and 4 cases of type Ⅳ. The morphological characteristics and injury mechanisms of FFP were analyzed. According to the treatment methods, the patients were divided into a conservative treatment group of 32 cases and a minimally invasive surgery group of 24 cases. The 2 groups were compared in terms of complication incidence, mortality and the Koval attenuation rate of walking ability after one-year follow-up.Results:There were mostly the fractures of pubic branches on both sides of the pubic symphysis and compression fractures of the sacral wing caused by lateral crush injury. The 2 groups were comparable due to no significant differences in the preoperative general data between them other than FFP classification (n P>0.05). By one year after treatment, the conservative treatment group had a complication incidence of 34.4% (11/32), a mortality of 9.4% (3/32) and a Koval attenuation rate of walking ability of 13.8% (4/29) while the minimally invasive surgery group had a complication incidence of 20.8% (5/24), a mortality of 4.2% (1/24) and a Koval attenuation rate of walking ability of 8.7%(2/23), showing no significant difference between the 2 groups (n P>0.05).n Conclusions:The injury mechanism of geriatric FFP is mostly lateral compression injury. The fracture sites are mostly located on both sides of the pubic symphysis, pubic branches and the sacral wing of anterior and posterior rings simultaneously. Although there may be no significant difference in complication incidence, mortality or Koval attenuation rate of walking ability between conservative treatment and minimally invasive surgery after one year, the minimally invasive surgery deals with more unstable fracture types.