Examining Care of Patients with Pelvic Fragility Fractures (PFF) in a Model Three Centre: What Can We Do Better?

Abstract Background Pelvic fragility fractures (PFF) are an increasingly common cause of emergency presentations among older adults. Despite their rising incidence, the care of patients with non-hip fragility fractures often lacks the multidisciplinary input and structured pathways available for neck of femur fractures. Building on the success of the Irish Hip Fracture Database and orthogeriatric models of care, this study explores outcomes of patients with PFFs, without a standardized model of care. Methods Patients aged >65 years with conservatively managed pelvic fractures of the pubic ramus, acetabulum, or sacrum/sacral ala were identified via local HIPE data from January 2024 to March 2025 (n = 91). Patients were excluded if the fracture was because of high-impact trauma (e.g., road traffic collisions). A retrospective chart review was undertaken. Results A total of 62 patients met inclusion criteria. The median age was 83 years; the majority were female (n = 45). All injuries resulted from low impact falls consistent with insufficiency or fragility fractures. 77% of patients had two imaging modalities to confirm diagnosis (n = 48) and 80% presented from home (n = 50). A falls assessment was conducted in only 27 patients (43%). A bone health assessment was not undertaken for 40% of patients (n = 25) and 48% (n = 30) were not provided with any bone protection on discharge from the acute hospital setting. 19% (n = 12) of patients were transferred to off-site rehabilitation facilities. 8% (n = 5) patients died during admission. Conclusion Our findings highlight a gap in the structured care of patients with PFF. The absence of standardized falls and bone health assessments represents a missed opportunity to reduce future fracture risk and subsequent hospital admissions. This study bolsters the need for the development of a national care bundle for PFF, mirroring the Irish Hip Fracture Database structure.