{
  "abstract": "Aims and Objectives Background: The initiation of bone protection to prevent the associated mortality from further fragility fractures is an important role undertaken by Fracture Liaison Services (FLS). According to the 2025 NHFD report, people with a pubic ramus fracture (PRF) are the next largest group of fragility fracture admissions behind hip fractures. Management of stable PRFs is comparable to post-hip fracture surgery care. Despite this, a proportion of PRF patients are discharged home without referral to FLS, resulting in a missed opportunity for secondary fracture prevention treatment. Aim: To identify the number of patients presenting to the Emergency Department (ED) with a PRF between December 2023-2024 who were discharged without FLS follow-up.Method and Design Methods: All Pelvic imaging requested by ED for patients >65 between Dec 2023-Dec 2024 were included for review. After exclusions, 41 patients were analysed. A search was performed on the FLS database (FLS-DB) and electronic patient record (EPR) for primary fracture referral details, demographic data, mortality and admission/discharge status and location. Those not captured on FLS-DB were classed a ‘missed referral’ for secondary fracture prevention.Abstract 4218 Figure 1Results and Conclusion Results: 66% patients presenting with a PRF were not known to FLS. In total 44% patients admitted from home were not discharged back home and the mortality at one month was 7%. Overall, 32% of the cohort were not referred to FLS, increasing to 40% if discharged directly from ED. Conclusion: There was a notable proportion of patients with PRFs without a referral to FLS, particularly those discharged directly from ED. The morbidity and mortality associated with this fragility fracture highlight the importance of FLS referrals for bone protection assessment. This data has been presented locally at departmental clinical governance meetings and teaching; additionally, guidance has been developed to improve this pathway for PRF FLS referrals. A re-audit is currently taking place.",
  "authors": [
    {
      "affiliations": [
        "Royal Berkshire Hospital"
      ],
      "name": "Charlotte Morris"
    },
    {
      "affiliations": [
        "Royal Berkshire Hospital"
      ],
      "name": "Ryan Brown"
    },
    {
      "affiliations": [
        "Royal Berkshire Hospital"
      ],
      "name": "Liza Keating"
    },
    {
      "affiliations": [
        "Royal Berkshire Hospital"
      ],
      "name": "Victoria Britton"
    },
    {
      "affiliations": [
        "Royal Berkshire Hospital"
      ],
      "name": "Libby Kington"
    }
  ],
  "title": "4218 Audit on fracture liaison service referrals resulting from pubic rami fracture identification on pelvic imaging undertaken by the emergency department",
  "uid": "b0c793fa-eb9c-50dd-9fab-e73be7ff3d90"
}