Pelvic fragility fractures in older adults are increasingly common and associated with significant morbidity, loss of independence and high mortality. Yet current care varies widely due to the absence of standardised regional protocols, resulting in inconsistent diagnostics, treatment decisions and follow-up.
The PELVIC study is a multicentre, stepped-wedge, randomised controlled trial evaluating whether implementing a structured clinical pathway can improve outcomes for patients aged 50 and older who sustain pelvic fragility fractures after low-energy trauma. With the primary goal to restore mobility and independence, the pathway synthesises existing evidence and expert practice to optimise the entire care process. Key components include streamlined diagnostic protocols (e.g., CT-imaging as diagnostic golden standard), structured treatment guidance (operative or conservative), standardised pain management, early mobilisation through physiotherapy and geriatric assessment for osteoporosis and falls.
The primary outcome is mobility, quantified by the Parker Mobility Score, with secondary measures including functional performance, quality of life, return to home rates, pain levels, new falls, complications and mortality after one year follow-up.
By implementing the pathway across nine participating regional trauma centres, we aim to determine whether harmonised clinical decision-making and follow-up translates into better functional recovery and quality of life for this vulnerable population. The results will inform future guidelines and may standardise pelvic fragility fracture care across the Netherlands.