From the Research
The incidence and prevalence of pubic ramus fractures in long-term care settings is significant, with an estimated annual incidence of 3-5 per 100 residents, and a one-year mortality rate of 16.7% to 23% 1, 2. The true prevalence may be underestimated as many pubic ramus fractures present with vague symptoms and may go undiagnosed. Some key points to consider include:
- Risk factors specific to long-term care residents include decreased mobility, muscle weakness, poor balance, cognitive impairment, and multiple comorbidities 3, 4.
- Management typically involves pain control, limited weight-bearing as tolerated, and gradual mobilization, with most patients returning to their baseline functional status within 8-12 weeks 3, 4.
- Prevention strategies should focus on fall prevention programs, osteoporosis screening and treatment, and environmental modifications to reduce fracture risk in this vulnerable population 1, 2.
- Women are affected more frequently than men, with a ratio of approximately 3:1, largely due to higher rates of osteoporosis 3, 4.
- The strongest predictor for 1-year mortality was complications during admission and a dependent ambulatory status 1. Some of the key statistics from recent studies include:
- One-year mortality rate was 16.7% to 23% 1, 2
- 34% of patients were institutionalized at discharge 1
- 49% lost their independent mobility status and 40% of the patients did not experience a full recovery 1
- The median EQ-5D-Index Value was 0.62, indicating a decreased quality of life 2
- Average Parker Mobility Score was 4, indicating restricted mobility 2
- 21.2% of patients experienced additional fragility fractures within a two-year period 2