High rate of sacral fractures in elderly patients presenting pubic rami fractures

BACKGROUND: Pubic rami fractures are common in the elderly, resulting from low energy traumatic falls. The recovery of some of these patients may be disproportionately slow. OBJECTIVE: To investigate the characteristics of older patients admitted with pubic rami fractures and possible associated pelvic fractures. PATIENTS AND METHODS: We have prospectively examined nineteen consecutive female patients admitted from the emergency ward with a diagnosis of pubic rami fractures, during a one-year period. Patients underwent bone scans and pelvis computerized tomography. RESULTS: Six of these patients had associated sacral fractures as demonstrated by pelvic CT scan. None of these sacral fractures was diagnosed on admission to the emergency ward. CONCLUSION: There is a considerable high rate of association of combined pubic and sacral fractures. Greater awareness of this clinical condition is required.