Fragility fractures of the pelvis in the elderly: protocol for an international prospective multicentre observational cohort study.

INTRODUCTION: Fragility fractures of the pelvis (FFPs) are low-energy osteoporotic fractures that primarily affect elderly patients. They are associated with substantial morbidity, mortality and healthcare burden, and their incidence continues to rise as the global population ages. Despite the availability of dedicated classification systems and advances in surgical techniques, high-quality evidence to guide optimal management remains limited, and treatment algorithms are not standardised. To address these gaps, we established an international, observational cohort study designed to collect comprehensive data on patients with FFP and varying degrees of pelvic instability. The study aims to evaluate outcomes of non-operative and operative management and to identify predictors of favourable outcomes. METHODS AND ANALYSIS: This international, prospective, multicentre, observational cohort study will enrol approximately 420 patients aged ≥65 years with FFP (types II-IV) over a 4-year period at 10 large AO Trauma centres in the USA, Canada, Japan, Hong Kong, France, Switzerland, the Netherlands and Germany. Patients will be followed for up to 12 months. Data collected will include fracture characteristics, treatment details, radiological and functional outcomes, patient-reported outcomes, mortality and procedure-related adverse events. All treatments will adhere to the standard of care at each participating centre. ETHICS AND DISSEMINATION: Ethics approval was obtained from the responsible ethics committee at each participating site before recruitment. All patients will be enrolled following an informed consent process approved by the relevant ethics committee. Study results will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER: NCT04182776.