All superior pubic ramus fractures are not created equal.

OBJECTIVE To assess whether patients with a fracture of the high superior pubic ramus have functional outcomes worse than those of the lower or more central superior pubic ramus. METHOD We carried out a retrospective cohort study of all patients with pubic ramus fractures seen in either the emergency department or outpatient clinic of a level-1 trauma centre in Montreal. Patients were grouped according to their fracture location, determined from radiographs of the anteroposterior pelvis. Harris Hip Score and Musculoskeletal Functional Assessment questionnaire (short form) data were determined by an independent observer. RESULTS Both the hip score (p = 0.0024) and functional assessment (p = 0.0304) indicated that patients in the group with high superior fractures had significantly poorer functional status. CONCLUSION High superior pubic ramus fractures have a poorer prognosis with respect to functional outcome.