POOR OUTCOME WITH HIGH PUBIC RAMUS FRACTURES

Abstract

This study attempted to ascertain if patients with high superior pubic ramus fractures (HSPR) have worse clinical functional outcomes than patients with low superior pubic ramus fractures (LSPR). A retrospective cohort of patients was examined. A statistically significant difference was found with respect to Harris Hip Score, MFA score, Bother Index, and Functional Index. Patients with LSPR fractures consistently scored better on mobility and activity of daily living functional testing. Patients with HSPR fractures were limited in physical abilities and lifestyle adjustment. This study illustrates a need to re-examine our treatment of high pubic ramus fractures.

The purpose of this study was to ascertain if patients with high superior pubic ramus fractures have worse clinical functional outcomes than patients with low superior pubic ramus fractures.

Patients with Low Superior Pubic Ramus (LSPR) fractures consistently scored better on mobility and activity of daily living functional testing. Patients with High Superior Pubic Ramus (HSPR) fractures were more limited in physical abilities and lifestyle adjustment.

No distinction of level of this common fracture is routinely distinguished with treatment usually independent of level. This study illustrates a need to re-examine our treatment of high pubic ramus fractures.

A statistically significant difference was found when the HSPR fracture group was compared to the LSPR fracture group with respect to Harris Hip Score (P=0.0024), MFA score (P=0.0304), Bother Index (P=0.0338), and Functional Index (P=0.0385), and had hip pain which was a limiting factor (P=0.011).

This is a retrospective cohort study of patients sustaining a superior pubic ramus fracture. The criterion for grouping was fracture proximity to the acetabulum. MFA (Short Form) and Harris Hip Score were performed. A physical exam was performed on all patients. The two groups were compared using the Wilcoxon test for continuous variables and the Chi-square test for contingency tables.

These fractures are commonly felt to be of minimal significance. Common treatment regimes consist of pain control and early mobilization. The etiology of the increased pain and functional disability in patients with HSPR fractures is unclear. Our hypotheses include labral tear and missed true acetabular fractures.