Early functional recovery after operative treatment for fragility fracture of the pelvis: A prospective observational study.

Abstract

PurposeFragility fractures of the pelvis (FFPs) are associated with substantial morbidity and mortality in elderly patients. Although operative treatment is often performed for FFP to facilitate early mobilization, its overall clinical benefit remains controversial. This study aimed to determine whether operative treatment is associated with clinically meaningful recovery after FFP.MethodsThis prospective observational study included 46 consecutive patients aged ≥65 years who were treated for FFP at our institution between July 2023 and February 2025. Baseline clinical, functional, and laboratory data were collected at admission. The primary outcome was favorable recovery at 3 months, defined as a composite of survival, computed tomography-confirmed radiographic union, and functional recovery as determined by a modified Majeed pelvic score ≥55. Secondary outcomes included favorable recovery at 6 and 12 months.ResultsOf the 46 patients, 16 underwent operative treatment and 30 received non-operative management. Favorable recovery was significantly more common at 3 months in the operative group than in the non-operative group (43.8% vs 13.3%, p = 0.032) but not at 6 months (50.0% vs 46.7%, p > 0.999) or 12 months (50.0% vs 40.0%, p = 0.548). Baseline characteristics did not differ significantly between the groups; although the non-operative group was approximately 5 years older, this between-group difference decreased over time.ConclusionOperative treatment of FFP was associated with a higher favorable recovery rate at 3 months but not at 6 or 12 months. Given the small sample size and non-randomized treatment allocation, these findings should be interpreted cautiously.