Advice after your nerve block for surgery
On this page…
You or your relative has been admitted with a pubic rami fracture
This page has been designed for you by health professionals to provide you and your relatives with information that may help guide you through your hospital stay.
Our aim is for you to regain an appropriate level of function and return to your home environment with a suitable level of assistance.
What is a pubic rami fracture?
The pubic rami are a group of bones that make up the pubis which is one of the bones that make up the pelvis. The pubis consists of a superior ramus and inferior ramus, which meet at the body of the pubis. Fractures can occur in either your superior or inferior pubic ramus or both.
Your pubic rami fracture will normally not require surgery and will be conservatively managed with the help of the hospital team. We anticipate a hospital stay of around 2 weeks, however, some patients may recover quicker and others may require a bit more time.
What causes a pubic rami fracture?
Trauma is the main cause of pubic rami fractures. This ranges from car accidents to falling from any height, but most commonly falling from standing.
Falls are common in older people, and one in three people over 65 will fall each year. As we get older our bones become weaker, making them more prone to breaking. Osteoporosis and other bone diseases can increase the effect of age and further weaken bone.
Conservative management
The Doctors looking after you may decide after reviewing your x-rays that they want to treat your injury conservatively (without surgery). They may decide not to do an operation if your fracture has remained well aligned, or if you have lots of other medical conditions which may put you at high risk of becoming unwell during a operation. The fracture will normally take 6 to 8 weeks to heal, but may take longer depending on the severity.
Pain management
There are a lot of muscle attachments around the pelvis and this can make movement very painful. It is essential to keep on top of your pain relief, if you feel that your pain is not controlled please inform a member of staff in the hospital or your GP at home. It is common that at rest you will feel no pain, but pain will generally increase on movement and weight bearing so please continue to take the recommended pain relief prescribed.
You can usually walk straight away with pubic rami fractures and your physiotherapist will encourage you to do so if you are well enough. This is because walking is the best thing for improving your circulation and speeding up fracture healing. It is important your pain is well managed to facilitate this.
Weight-Bearing status
The consultant looking after you will make a decision around how much weight you can put through your injured leg. Your Physiotherapist will assist in teaching you how to maintain these weight-bearing statuses. Below are all the weight-bearing statuses:
- Non Weight Bearing - This means you cannot put any weight through your injured leg. You should keep the foot of your injured leg off the floor.
- Limited Weight Bearing - This means you can put some weight, but not all of it, through your injured leg. The amount of weight will be determined by your consultant. Using a walking aid such as a wheeled zimmer frame or two crutches will assist you to maintain partial weightbearing.
- Unrestricted Weight Bearing - This means there is no restriction in how much weight you can put onto your injured leg.
Your ward team
You will be looked after on the ward by a variety of health professionals. All members should be wearing an identification badge to help you recognise them. Here is a brief reference guide of their roles:
Doctors:
- Doctors either wear their own clothes or scrubs.You will be under the care of an Orthopaedic Consultant
- If you’re 60 and over, you will be seen by our Consultant Orthogeratrician and their team who specialise in the management of fragility fractures and medical issues in the older person alongside the orthopaedic team.
Nursing staff:
- The role of a nurse is to administrate medication, assist with personal care and monitor your well-being.
- Nursing staff wear blue trousers and tunics in shades of blue. Ward sister (navy blue), senior sister (royal blue) and junior nurse (pale blue).
Health care assistants:
- They work with the nurses and are there to assist you with any needs on the ward.
- They wear black trousers and lilac tunics with navy trim.
Physiotherapists:
- The Physiotherapist will get you out of bed and work with you regularly with the aim to get you on your feet as soon as possible
- They will provide you with any mobility aids you may require
- They wear navy blue trousers or shorts and a white polo top or tunic with a navy trim
Occupational Therapists (OT):
- The OT will assess your needs to return home and will provide you with any equipment and help that you may need to go home.
- They wear green trousers and a white polo top or tunic with a green trim
Other ward staff:
- Pharmacy (green tunics) ensure you have been prescribed appropriate medication and prepare any medication for home.
- Porters (navy blue top and trousers) ensure you get to any areas of the hospital outside of the ward for medical reasons.
- Dieticians (burgundy tunics with light blue trim) will assess your nutritional needs if needed. They are able to advise you on what food and drink you should be consuming, and can provide additional nutritional support if required.
Day 1
- You will be reviewed by the orthopeadic team
- You are encouraged to eat and drink normally. It’s important that you keep hydrated to help with recovery.
- You will receive regular pain relief, but you may be written up for additonal pain relief if your pain is severe or to allow you to mobilise more easily. You will need to request this extra pain relief.
- You will be assessed by a physiotherapist, taught the exercises at the back of this booklet and mobilised out of bed. Once you have been taught the exercises, it is your responsibility to carry these out indepedently if able.
- We encourage patients to be in their own clothes so ask your visitors to bring items such as supportive footwear and comfortable clothing to help promote your recovery.
Day 2 Onwards
- You should be sitting out of bed daily, ready for physiotherapy sessions - you will be reviewed by the Physiotherapist regularly with the aim to walk further every day.
- If you need to climb stairs at home you will practise this in hospital.
- You should be carrying out your exercises 3 times per day independently if able to.
- You should be getting dressed daily, please ask for help from health care asisstants or nursing staff if needed.
- The OT, if needed, will assess how you will manage daily tasks and if you may need any aids at home.
- You will be reviewed by the Orthogeriatric team (if over 60).
- Your risk of further falls will be assessed and acted upon (medication review, strength and balance exercises, occupational therapist assessment)
- Your risk of osteoporosis will also be assessed and you may be started on bone protection (vitamin D, calcium, bisphosphonates), sent for a special scan of your bones or referred to the outpatient rheumathology clinic for follow up.
Leaving the Hospital
- The Doctors will need to declare you as medically stable for discharge prior to going home and provide you with discharge letters. This may happen at a different time to when the physiotherapy and occupational therapy team deem you are safe to return home.
- Depending on your mobility, you will need to discuss transport to get home, if you need assistance the nurses can help arrange this
- Pharmacy will arrange your medication for going home.
- Any outpatient or community referrals will be made upon your discharge.
- If help is required at home for personal and domestic care, this will be put in place prior to your discharge from hospital. However, some patients may need a period of time in a step-down hospital in their local area prior to going home to progress with their independence.
- Your discharge plans may change as you improve whilst you are on the ward. These plans are made by the professionals that work alongside you and have assessed your needs, however this will be discussed with you and your family at the time.
Contact us
If you have any queries relating to this information, please contact the Orthopaedics service.
About this information
Service:
Orthopaedics
Reference:
BB/105
Approval date:
1 April 2026
Review date:
1 April 2029
Click ‘show accessibility tools’ at the bottom of the page
Then click ‘select language’
Alternative formats
You can use the accessibility toolbar at the bottom of your screen to:
-
Change the text size
-
Adjust the font
-
Modify the colour contrast
-
Use the translate function
If you would like this information in another format, such as Braille, audio, or easy read, please speak to a member of staff.
You can also print as well as download as PDF using the “Print this page” button at the end of the page.
Staff will print a copy for you on request
Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.