High energy pelvic ring fractures, an overview over the past decade

Abstract

Intrapelvic bleeding in high energy pelvic ring fractures contributes to their high mortality. Pelvis surgical stabilization is often delayed while diagnostic tests are performed in order to exclude other injuries associated with trauma. Aim To determine which pelvic ring fractures are associated with increased mortality, whose stabilization should be considered as a priority and to determine the prognostic value of the existing pelvic ring fractures classification systems. Cohort study Selected patients admitted with high energy fracture of the pelvis in the same trauma center between 2005 and 2015. Excluded patients with hemorrhagic extra-pelvic injuries and/or previous hematologic or cardiac disease. Analyzed age, gender, trauma etiology, shock index, hemoglobin, use of pressor amines, blood transfusions plasma, angiography and vascular embolization. X-rays and CT scans were analyzed by two independent observers and fractures were classified by the following systems: Young and Burgess,Tile, Letournel (anatomic) and Denis. We analyzed the association between the different fracture patterns and the development of shock and or need of vascular embolization. Statistical analysis with IBM SPSS Statistics 20. 102 patients. Average age 43 years. Male-female 2-1. Lesional mechanism 46% running over, 32% road accident and 22% falling from heights. We found a statistically significant association between shock development, superior IGS 2 index and higher risk for embolization and the following fractured patterns–sacral fractures in Denis zone 1 ( P P P = 0.04) and Denis zone 2 ( P P P = 0.026), iliac wing fractures ( P P P P P P