The truth behind the pubic rami fracture: identification of pelvic fragility fractures at a university teaching hospital

摘要

Older patients presenting on the acute medical take with pelvic fragility fractures (PFF) represent an increasing epidemic. The most common pelvic fracture identified by plain X-ray is that of the pubic rami. PFF are painful and despite optimal analgesia, many of these patients struggle to mobilise. Between 60% and 80% of patients have fractures of the posterior pelvic ring, namely of the sacrum, which are overlooked and not visible on plain X-ray. Sacral fractures are unstable and load-bearing, thus increasing the likelihood of pain-dependent mobility reduction and the risks that this poses in an older population. Minimally invasive sacroplasty is available and has been shown to improve pain-related outcomes. We aimed to quantify the number of patients progressing to further pelvic imaging in the form of computed tomography (CT) or magnetic resonance imaging (MRI) and the prevalence of combined pubic rami and sacral fractures.