Rising burden of pelvic fracture: A need for prompt identification to minimise harm

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I Singh1, Avtar Singh2, Aparna Vinod2, Amara Williams2, Sophie Maggs2, Chris Edwards3
1 Consultant Geriatrician/Bone Health Lead, Aneurin Bevan University Health Board, Wales (UK); 2 Bone Health/FLS team, Aneurin Bevan UHB, Wales; 2 Medical Student, Cardiff University; 3 Consultant Clinical Scientist, Aneurin Bevan UHB, Wales.
Clinical Quality
fracture & trauma
Bone Health

Abstract

Introduction: Pelvic fractures are a common fragility fracture, associated with adverse clinical outcome but often under recognised. There is a wide range of incidence 6.9-78.6/100,000/year being reported in the UK. There is a paucity of studies describing incidence and adverse outcomes including mortality and re-fracture risk. The objective of this study is to measure incidence of fragility fracture for the population of Gwent (592,000), compare baseline characteristics with all fragility fractures and measure clinical outcomes of pelvic fractures.

Methods: All fragility fracture patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) between January 2022 and June 2024 were reviewed retrospectively. The clinical outcomes for pelvic fracture including re-fracture and mortality were analysed at 12 months.

Results: A total of 5310 fragility fracture patients were observed for 2.5 years and 5% (n=263) had pelvic fracture. The incidence of pelvic fracture over 2.5 years was 17.7/100,000/year. However due to improved fragility fracture case identification, incidence for the year 2024 was 36.6/100,000/year. 52.1% (n=137) patients with pelvis fracture had previous fragility fracture.

Mean age of all pelvic fracture patients (n=263) was 83.7±8.4, whereas mean age for all the fragility fracture patients seen by AB-FLS (n=5310) was 79.7±8.7, the difference being statistically significant (p<0.001). Females were 81.7% (n=215) which was higher as compared to all females seen by AB-FLS were 77.8% (n=4136), but this was not significant on difference between proportions test, p=0.18. Only 5.3% patients were admitted from care home (n=14) which was comparable to all the patients seen by AB-FLS (5.5%, n=294) and not significant on difference between proportions test, p=0.97.

Moreover, 60.1% (n=158) pelvic fracture patients were hospitalised which was higher than all fragility fracture admitted to hospital (48.4%, n=2570) and was a significant difference between proportions test, p=0.004

61.2% (n=161) were started on osteoporosis treatment. 23.6% (n=62) pelvic fracture patients died at 12 months. Although 85.2% (n=224) had no fracture, 14.8% (n=39) had re-fracture at 12 months. 11.4% (n=30) re-fractured at 12-months involving hip, wrist, spine, humerus or pelvis. 2.7% (n=7) of the total pelvic fracture had hip fracture within 12 months.

Conclusion: Over 60% patients with pelvis fracture required inpatient care which was significantly higher in comparison to all fragility fracture admissions (48%). Pelvic fractures were associated with high one-year mortality (23.6%). More research is needed to close this gap, so we can better understand the impact of pelvic fractures on health services.

Comments

Thank you for this interesting poster. I was wondering if there were any patient characteristics other than age and gender that were more associated with pelvic fracture than other fragility fractures (e.g. clinical frailty score, certain co-morbidities)?

Submitted by liamljones93 on

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This is a very relevant and important topic. The rising burden of pelvic fractures, especially among the elderly and osteoporotic population, highlights the need for early recognition and timely management. Pelvic fractures are often associated with significant morbidity, prolonged hospital stays, and increased mortality, so prompt identification can make a major difference in patient outcomes. Your focus on minimizing harm through early diagnosis and intervention is well-placed, as it reinforces the importance of multidisciplinary care, rapid imaging, and early stabilization. This research effectively draws attention to a growing public health concern and the need for improved screening and preventive strategies.

 

Submitted by deepakdager199… on

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This retrospective study clearly highlights the high burden of pelvic fractures, noting over 60% required inpatient care and a significant one-year mortality rate of 23.6%. The findings underscore the critical need for better understanding and improving health services to manage these severe fragility fractures.
The findings underscore the critical need for better understanding and improving health services to manage these severe fragility fractures

Submitted by arvinddagar008… on

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This retrospective study clearly highlights the high burden of pelvic fractures, noting over 60% required inpatient care and a significant one-year mortality rate of 23.6%. The findings underscore the critical need for better understanding and improving health services to manage these severe fragility fractures.
This retrospective study clearly highlights the high burden of pelvic fractures, noting over 60% required inpatient care and a significant one-year mortality rate of 23.6%. The findings underscore the critical need for better understanding and improving health services to manage these severe fragility fractures

Submitted by arvinddagar008… on

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We value your feedback and sharing your feedback. Inder Singh, Wales 

Your poster is clear, informative, and visually engaging. The layout makes the message easy to understand, and it really encourages people to take proactive care of their core support.

Submitted by anjupanghaal7@… on

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Thank you for this interesting poster.. This research effectively draws attention to a growing public health concern and the need for improved screening and preventive strategies.

Submitted by nitusingh52200… on

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You've synthesized the key findings of pelvic fractures and have summarized the main research amazingly. 

The significance of your work is appreciated in health services 

Submitted by shefali0224@gm… on

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Nice study. How confident are you that the FLS is able to pick up all fractures?
 

Submitted by iainwilkinson1_13125 on

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Our pick up rate on pelvis fractures have been increased over the last three years. This is mainly due to our partnership and collaboration with Radiology and we are hoping this will continue to build over time. Next step is to build more partnership between OG and FLS teams and these patients are commenced on treatment and followed by Primary care

Submitted by inderpal.singh on

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An excellent poster! Visually clear and concise, highlighting truly important information and the need for more research to improve outcomes. Let's hope that research happens, or this can be the catalyst and platform for you to work on this yourself. Thank you

Submitted by arun.joshi3@nhs.net on

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Great work, what sort of recommendations/changes would you consider if you were to repeat PDSA cycles to improve patient outcomes?

Submitted by cain.donnelly2… on

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Prompt identification by linking with Radiologists and reporting radiographers to report pelvic ring fractures, Partnership with OG/FLS teams to commence prompt treatment, follow-up in the community. Patient education and awareness on osteoporosis and pain management. 

This is very observational service outcome data and all we are doing is linking more with radiologists to use the keyword 'fracture' so that FLS teams can capture all these patients, who could be admitted to any medical, surgical or OG wards.