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Peer-reviewedCC BYBrain & spine

In-hospital complications and treatment decision-making in osteoporotic pelvic ring fractures: The Role of the OF-Pelvis Score.

  • Felix C Kohler1
  • Philipp Schenk2
  • Pamela Schanderl3
  • Volker Zimmermann4
  • Bernhard W Ullrich5,6
  • Martin Naisan7
  • Erik Wegner8
  • Michael Müller9
  • Frank Hartmann10
  • Klaus J Schnake11
  • Imke Schmerwitz12
  • Lars Behr13
5 more authors
  • Max J Scheyerer14
  • Robert Pätzold15
  • Sebastian Grüninger16
  • Georg Osterhoff3
  • Ulrich J A Spiegl3,17
17 affiliations
  1. 1Department of Trauma, Hand and Reconstructive Surgery and Orthopedics, Universitätsklinikum Jena - Friedrich-Schiller-University, Jena, Germany.
  2. 2Innovationhub for Musculoskeletal Surgery Halle (IMCH), BG Klinikum Bergmannstrost Halle gGmbH, Halle (Saale), Germany.
  3. 3Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
  4. 4Department of Trauma and Orthopedic Surgery, Klinikum Traunstein, Traunstein, Germany.
  5. 5Department of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost Halle, Halle, Germany.
  6. 6Clinic for Trauma- and Reconstructive Surgery UMH, Halle, Germany.
  7. 7Spine Center, St. Josef-Hospital Wiesbaden, Wiesbaden, Germany.
  8. 8Department of Trauma and Orthopedic Surgery, Universitätsmedizin Mainz - Johannes Gutenberg-University, Mainz, Germany.
  9. 9Department of Orthopedic and Trauma Surgery, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany.
  10. 10Department of Trauma Surgery, Diakonie Krankenhaus, Bad Kreuznach, Germany.
  11. 11Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany.
  12. 12Clinic for Orthopedic Surgery, Sports Traumatology and Trauma Surgery, Städtisches Klinkum Wolfenbüttel, Wolfenbüttel, Germany.
  13. 13Interdisciplinary Center for Spine and Neurotrauma, Sana Klinikum Borna, Borna, Germany.
  14. 14Department of Trauma and Orthopedic Surgery, Universitätsklinikum Düsseldorf - Heinrich Heine University, Düsseldorf, Germany.
  15. 15Department of Trauma and Reconstructive Surgery, BG Unfallklinik Murnau, Murnau, Germany.
  16. 16Department of Orthopedics and Traumatology, Klinikum Nürnberg, Nuremberg, Germany.
  17. 17Clinic for Trauma Surgery and Orthopaedics, Munich Harlaching, Sanatoriumspl. 2, 81545 München, Germany.
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Abstract

Osteoporotic pelvic ring fractures (OPRFs) are associated with immobility-related complications and functional decline. The OF-Pelvis classification and score support treatment decision-making, but their relationship with in-hospital complications remains unclear. This study investigated whether the OF-Pelvis Score, fracture morphology, treatment modality, or patient-related factors predict in-hospital complications and short-term functional recovery. In this prospective multicentre cohort study, 390 patients with OPRFs treated at 14 German trauma centers were analysed. Fractures were classified according to the OF-Pelvis system, and score-based treatment recommendations were compared with actual treatment. Predictors of complications were assessed by logistic regression, and functional outcomes from treatment decision to discharge were analysed using repeated-measures general linear models. Treatment information was available for 386 patients; 254 (66%) underwent surgery and 132 (34%) received conservative treatment. Complications occurred in 102 patients (26%). Treatment was concordant with the OF-Pelvis Score recommendation in 90% of cases, supporting its role in treatment decision-making. However, the score did not predict in-hospital complication risk. Age was the only independent predictor of complications, whereas treatment modality, baseline mobility, pain, and ASA classification were not independently associated with adverse events. Functional outcomes improved significantly during hospitalization. The OF-Pelvis Score reflected real-world treatment decisions but did not predict complication risk. Complications were primarily associated with patient-related factors, particularly age, supporting targeted geriatric co-management and complication prevention.

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Cite

BibTeXRIS
BibTeX
@article{kohler2026inhospital,
  title = {{In-hospital complications and treatment decision-making in osteoporotic pelvic ring fractures: The Role of the OF-Pelvis Score.}},
  author = {Felix C Kohler and Philipp Schenk and Pamela Schanderl and Volker Zimmermann and Bernhard W Ullrich and Martin Naisan and Erik Wegner and Michael Müller and Frank Hartmann and Klaus J Schnake and Imke Schmerwitz and Lars Behr and Max J Scheyerer and Robert Pätzold and Sebastian Grüninger and Georg Osterhoff and Ulrich J A Spiegl},
  journal = {Brain \& spine},
  year = {2026},
  month = oct,
  doi = {10.1016/j.bas.2026.107481},
  url = {https://europepmc.org/article/MED/42999624},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - In-hospital complications and treatment decision-making in osteoporotic pelvic ring fractures: The Role of the OF-Pelvis Score.
AU  - Felix C Kohler
AU  - Philipp Schenk
AU  - Pamela Schanderl
AU  - Volker Zimmermann
AU  - Bernhard W Ullrich
AU  - Martin Naisan
AU  - Erik Wegner
AU  - Michael Müller
AU  - Frank Hartmann
AU  - Klaus J Schnake
AU  - Imke Schmerwitz
AU  - Lars Behr
AU  - Max J Scheyerer
AU  - Robert Pätzold
AU  - Sebastian Grüninger
AU  - Georg Osterhoff
AU  - Ulrich J A Spiegl
PY  - 2026
DA  - 2026/10/27
JO  - Brain & spine
DO  - 10.1016/j.bas.2026.107481
UR  - https://europepmc.org/article/MED/42999624
AB  - Osteoporotic pelvic ring fractures (OPRFs) are associated with immobility-related complications and functional decline. The OF-Pelvis classification and score support treatment decision-making, but their relationship with in-hospital complications remains unclear. This study investigated whether the OF-Pelvis Score, fracture morphology, treatment modality, or patient-related factors predict in-hospital complications and short-term functional recovery. In this prospective multicentre cohort study, 390 patients with OPRFs treated at 14 German trauma centers were analysed. Fractures were classified according to the OF-Pelvis system, and score-based treatment recommendations were compared with actual treatment. Predictors of complications were assessed by logistic regression, and functional outcomes from treatment decision to discharge were analysed using repeated-measures general linear models. Treatment information was available for 386 patients; 254 (66%) underwent surgery and 132 (34%) received conservative treatment. Complications occurred in 102 patients (26%). Treatment was concordant with the OF-Pelvis Score recommendation in 90% of cases, supporting its role in treatment decision-making. However, the score did not predict in-hospital complication risk. Age was the only independent predictor of complications, whereas treatment modality, baseline mobility, pain, and ASA classification were not independently associated with adverse events. Functional outcomes improved significantly during hospitalization. The OF-Pelvis Score reflected real-world treatment decisions but did not predict complication risk. Complications were primarily associated with patient-related factors, particularly age, supporting targeted geriatric co-management and complication prevention.
SN  - 2772-5294
ER  -