Fractures of the pubic rami: a retrospective review of 534 cases

Abstract

Introduction: Fractures of the pubic rami are typically classified as stable injuries. The current treatment strategies involve pain management and mobilization. However, pain-dependent immobilization may pose a serious hazard to patients with severe preexisting co-morbidities. There is paucity of literature on the outcome and mortality of these patients.

Methods: We retrospectively analysed 534 patients with these injuries. The following parameters were examined: gender, age, mechanism of injury, fracture pattern, length of hospital stay, care after discharge, number of outpatient follow-ups, and 1-year mortality. Multiple logistic regression analysis was performed for the assessment of factors influencing 1-year mortality.

Results: The observed 1-year mortality in the patients group was further compared to a virtual control group with the same age and gender distribution. Women were older and more frequently injured as a result of a simple fall. Age was the only factor to be predictive of 1-year mortality. Mortality increased with higher age in both the patient and the control group, but mortality was higher in the patients group in all age groups. This difference was significant for patients > or =90 years of age. Pubic rami fractures are a heterogeneous cohort of injuries and might not be as benign as thought in patients with severe preexisting co-morbidities.

Conclusion: Prospective studies are needed to better gauge the outcome after pubic rami fractures.