P-623: Fragility pubic rami fractures: epidemiologic study and results of patients managed conservatively

摘要

Background: Most fragility fractures of the pelvic ring are diagnosed as fractures of the pubic rami and treated conservatively and were considered to be a neglected injury in the past. Material and method: We performed a retrospective review of hospital records of all patients aged 75 years old and above treated in our hospital for fractures of the pubic rami following low energy falls, managed conservatively and discharged from the emergency department, and followed up for 12 months. Results: We included 180 patients (90.6% female) with fragility fractures of the pubic rami. Mean age was 85.3 ± 5.2 years, and 12.8% had three or more points on the comorbidity score of the Charlson index. 17.3% were admitted to hospital in the 3 months following the fracture, mainly due to congestive heart failure, respiratory failure or renal failure. 29.6% were seen by their family physician, most commonly due to pain or delirium, or acute urinary retention. 5% had to be temporarily admitted to a nursing home due to the fracture. 30-day mortality following the fracture was 3.9%, and 13.5% at 1 year. The most common causes of death were aspiration pneumonia and heart failure. 9.5% suffered new fragility fractures in the year following the pubic rami fracture, with 5.6% suffering a hip fracture, usually intertrochanteric. Conclusions: Pubic rami fractures led to a high rate of hospital admissions and family physician visits due to medical complications. These fractures should be considered fragility fractures in need of orthogeriatric co-management.