{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:17:30Z","timestamp":1781777850996,"version":"3.54.5"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To determine the incidence of patients with isolated pubic rami fractures on computed tomography scans who have dynamic instability secondary to occult lateral compression pelvic ring injuries.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective comparison study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Urban level 1 trauma center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>This study included geriatric patients with isolated pubic rami fractures and inability to mobilize secondary to pain.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Lateral stress radiographs of pelvis to evaluate for \u22651 cm dynamic instability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Physical therapy clearance, hospital length of stay, and discharge location.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A total of 19 patients were identified over 12 months. Patients were predominantly geriatric (median age: 75 years, interquartile range: 67 to 90), woman (11\/19), with unilateral (17\/19) comminuted distal rami fractures (12\/19) sustained in ground-level falls (12\/19). Dynamic instability was identified in 42% of patients (8\/19). Magnetic resonance imaging, obtained in 6 of these patients, demonstrated occult posterior ring fractures in all cases. Patients with dynamic instability were more likely to have comminuted distal rami fractures (Nakatani type 1b) and a longer hospital length of stay. There was also a trend for these patients to be unable to clear physical therapy by discharge (63% (5\/8) versus 36% (4\/11)). The 90-day mortality rate of the cohort was 16% (3\/19).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients presenting with seemingly isolated pubic rami fractures on radiographs and computed tomography scans who are unable to mobilize may have occult lateral compression injuries with dynamic instability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002576","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T19:01:28Z","timestamp":1674673288000},"page":"356-360","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Geriatric Patients Presenting With Isolated Pubic Rami Fractures and Inability to Mobilize May Have Occult Lateral Compression Pelvic Ring Injuries With Dynamic Instability"],"prefix":"10.1097","volume":"37","author":[{"given":"Nicholas J.","family":"Tucker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Mauffrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8262-4065","authenticated-orcid":false,"given":"Joshua A.","family":"Parry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.3390\/jcm9082498","article-title":"Isolated pubic ramus fractures are serious adverse events for elderly persons: an observational study on 138 patients with fragility fractures of the pelvis type I (FFP type I)","volume":"9","author":"Rommens","year":"2020","journal-title":"J Clin 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