The importance of pelvic branch fractures: A comprehensive approach through the Anoia Fracture Liaison Service

Hip fractures and pubic rami fractures are common in older adults and are generally caused by low-energy trauma. While hip fractures require hospital admission, pubic rami fractures are often managed on an outpatient basis and receive less clinical and scientific attention. The aim of this study was to compare functionality, in-hospital complications, and two-year mortality between both fracture types.

A prospective descriptive study was conducted in the Orthogeriatric Unit of the Fracture Liaison Service (FLS), including patients over 69 years of age with fragility fractures. Clinical and functional variables at admission and discharge, in-hospital complications, and mortality at 3, 6, 12, and 24 months were analyzed.

A total of 285 patients were included, 80.35% of whom were women; 83.86% had hip fractures and 16.14% had pubic rami fractures. Length of hospital stay was longer in hip fractures (8.26 vs. 5.47 days; p<0.01), as was the proportion of patients with two or more complications (59.80% vs. 13%; p<0.01). No significant differences were found in baseline or discharge functionality: FIM (hip: 105.5; rami: 104.2; p=0.79), BI (hip: 74.6; rami: 78.5; p=0.36), CAS (hip: 2.47; rami: 2.78; p=0.21), FAC (hip: 1.85; rami: 2.18; p=0.06). Mortality was similar at all follow-up points (p=0.90).

When managed in a specialized orthogeriatric setting, pubic rami fractures show comparable outcomes to hip fractures in terms of mortality, functionality, and discharge destination. These findings support the need for rigorous clinical management of this type of fracture as well.