Correlation between Pelvic Bone Fracture Site and Arterial Embolization in Severe Trauma Patients: A Retrospective Study in a Single Korean Institute

Abstract

Background: Immediate identification of vascular injury requiring embolization in patients with pelvic bone fracture is not an easy task. There have been many trials of indicators of embolization in patients with pelvic bone fracture. Although the Young and Burgess classification is useful inmaking decisions about treatment, it is reported to have little value as an indicator of embolization in major trauma patients. Objectives: The aim of this study is to find fracture patterns for predicting vessel injury by analyzing pelvic radiographs taken from major trauma patients with pelvic bone fracture. Patients and Methods: Among major trauma patients with injury severity scores (ISS) higher than 15 who visited our emergency room from January 2011 to June 2014, 170 patients were found with pelvic bone fracture and thus pelvic computed tomography (CT) angiography was performed. Setting aside patients who met the exclusion criteria, 126 patients were enrolled in this study for analysis of the length of anterior pelvic ring displacement, fracture involving the greater sciatic notch, iliac bone fracture involving the sacroiliac joint and sacral fracture. Results: Anterior pelvic ring displacement in group I was shorter (3.8 mm) than that of Group II (18.0 mm), but without statistical signficance (P > 0.05). Although fracture involving the SI joint did not prove to be of statistical significance (P > 0.05), fracture involving the sciatic notch or sacrum was statistically significant (P < 0.05). Conclusions: Analzying fracture sites involving the sciatic notch and sacrum may help predict the need for embolization of arterial injury concommitant with pelvic fracture.