Prospective clinical feasibility assessment of the Osteoporotic Pelvis Fracture Score (OFP-Score)—a multicenter prospective cohort study

PURPOSE: To evaluate the feasibility of using the recently developed OF-Pelvis-Score (OFP-Score) for treatment decisions in patients with osteoporotic fractures of the pelvis (OFP) based on standard clinical diagnostics. METHODS: A multicenter prospective cohort study was conducted at 14 trauma centers including 375 consecutive patients who were treated for an OFP over a period of 19 months. All fractures were classified according to the OF-Pelvis-Classification (OFP-Classification). The decision for either conservative or surgical therapy was made independently of the OFP-Score recommendation. Final decisions were compared to the recommendations given by the OFP-Score. RESULTS: 375 patients with an average age of 81.0 years (± 7.6) were included, mainly female (85.6%). According to the OFP-Score, surgery was recommended in 60.5%, and conservative treatment was recommended in 21.9%. In 66 patients (17.6%) the score was undetermined with no treatment recommendation. In daily practice, 33.6% of the patients were treated conservatively and the remaining 66.4% operatively. Overall, the agreement between the OFP-Score and the performed treatment was 91%. The score was obtained in a mean of 3.1 min (± 2.9). All patients improved significantly with respect of VAS (p < 0.001) and ODI (p < 0.001) during their hospital stay. CONCLUSION: Patients with osteoporotic sacral fractures improved clinically both after surgical and conservative treatment. The OFP-Score-based therapy recommendations showed a promisingly high rate of agreement with the therapy of daily practice. The scoring method provides a structured framework that supports clinical decision-making, complementing clinical judgment and other evidence-based tools in guiding treatment choices.