Research Article| Volume 41, ISSUE 4, P411-414, April 2010

Ten-year mortality among hospitalised patients with fractures of the pubic rami


      In a case–control study, 99 patients aged over 60 years and admitted to hospital with an isolated single fracture of the pubic ramus were compared with age- and gender-matched patients without fractures, in terms of morbidity and mortality. Ten years of follow-up showed that the survival of patients with an isolated pubic ramus fracture was significantly lower than that of controls. The mortality rates of patients with isolated pubic ramus fractures at 1, 5 and 10 years were 24.7%, 64.4% and 93.8%, respectively. One-third of the mortality was due to cardiovascular events. A 20.2% complication rate was found during hospital admission, mainly caused by infectious diseases, including urinary tract infection and pneumonia. Thirty-three percent of the patients were temporarily or permanently admitted to a nursing home, because they were unable to mobilise independently.
      In conclusion, our study found significant morbidity and mortality among patients admitted to hospital for an isolated pubic ramus fracture, both during hospital admission and during 10 years of follow-up.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Boufous S.
        • Finch C.
        • Lord S.
        • Close J.
        The increasing burden of pelvic fractures in older people, New South Wales, Australia.
        Injury. 2005; 36: 1323-1329
        • Breuil V.
        • Roux C.H.
        • Testa J.
        • et al.
        Outcome of osteoporotic pelvic fractures: an underestimated severity. Survey of 60 cases.
        Joint Bone Spine. 2008;
        • Friedman S.M.
        • Mendelson D.A.
        • Kates S.L.
        • McCann R.M.
        Geriatric co-management of proximal femur fractures: total quality management and protocol-driven care result in better outcomes for a frail patient population.
        J Am Geriatr Soc. 2008; 56: 1349-1356
        • Hill R.M.
        • Robinson C.M.
        • Keating J.F.
        Fractures of the pubic rami. Epidemiology and five-year survival.
        J Bone Joint Surg Br. 2001; 83: 1141-1144
        • Kahn H.S.
        • Tatham L.M.
        • Patel A.V.
        • et al.
        Increased cancer mortality following a history of nonmelanoma skin cancer.
        JAMA. 1998; 280: 910-912
        • Kannus P.
        • Palvanen M.
        • Niemi S.
        • et al.
        Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970–1997 and alarming projections for the new millennium.
        Osteoporos Int. 2000; 11: 443-448
        • Karjalainen S.
        • Salo H.
        • Teppo L.
        Basal cell and squamous cell carcinoma of the skin in Finland. Site distribution and patient survival.
        Int J Dermatol. 1989; 28: 445-450
        • Koval K.J.
        • Aharonoff G.B.
        • Schwartz M.C.
        • et al.
        Pubic rami fracture: a benign pelvic injury?.
        J Orthop Trauma. 1997; 11: 7-9
        • Leung W.Y.
        • Ban C.M.
        • Lam J.J.
        • et al.
        Prognosis of acute pelvic fractures in elderly patients: retrospective study.
        Hong Kong Med J. 2001; 7: 139-145
        • Melton 3rd, L.J.
        • Sampson J.M.
        • Morrey B.F.
        • Ilstrup D.M.
        Epidemiologic features of pelvic fractures.
        Clin Orthop Relat Res. 1981; 155: 43-47
        • Morris R.O.
        • Sonibare A.
        • Green D.J.
        • Masud T.
        Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards.
        Postgrad Med J. 2000; 76: 646-650
        • Ragnarsson B.
        • Jacobsson B.
        Epidemiology of pelvic fractures in a Swedish county.
        Acta Orthop Scand. 1992; 63: 297-300
        • Rossvoll I.
        • Finsen V.
        Mortality after pelvic fractures in the elderly.
        J Orthop Trauma. 1989; 3: 115-117
        • Spencer J.D.
        • Lalanadham T.
        The mortality of patients with minor fractures of the pelvis.
        Injury. 1985; 16: 321-323
      1. Statistiek CBvd.

        • Taillandier J.
        • Langue F.
        • Alemanni M.
        • Taillandier-Heriche E.
        Mortality and functional outcomes of pelvic insufficiency fractures in older patients.
        Joint Bone Spine. 2003; 70: 287-289
        • van Helden S.
        • Cals J.
        • Kessels F.
        • et al.
        Risk of new clinical fractures within 2 years following a fracture.
        Osteoporos Int. 2006; 17: 348-354
      2. van Helden S, Geel van T, Geusens P, et al. Implementation of guidelines for osteoporosis and fall prevention in patients with a recent clinical fracture reduces the risk of new fractures. Maastricht University Medical Centre; submitted for publication.

        • Vidan M.
        • Serra J.A.
        • Moreno C.
        • et al.
        Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial.
        J Am Geriatr Soc. 2005; 53: 1476-1482