Instability of the pelvic ring and injury severity can be predictors of death in patients with pelvic ring fractures: a retrospective study

Toshiya Tachibana,Manabu Kirita,Seishiro Marukawa,Hideyuki Yokoi,Shinichi Yoshiya

doi:10.1007/s10195-009-0050-x

Toshiya Tachibana, Manabu Kirita + Show 3 more

Open Access

https://doi.org/10.1007/s10195-009-0050-x

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Abstract

BackgroundThe correlation between fracture type and mortality in patients with pelvic fracture has been previously investigated. The purpose of this study was to determine whether instability of the pelvic ring as assessed by Tile’s classification is a predictor of death in patients with pelvic fractures.Materials and methodsThe clinical course of consecutive patients with pelvic fractures was retrospectively reviewed. Eighty-seven patients with pelvic ring fractures were included in the study. As potential predictive factors, fracture type according to Tile’s classification, and generally used traumatic parameters (injury severity score, revised trauma score, and probability of survival) were analyzed.ResultsThe mortality was significantly higher in patients with unstable fracture patterns (P < 0.05). In non-survivors, index values of traumatic parameters were more severe than those in survivors (P < 0.05).ConclusionThe present study suggests that patients with unstable pelvic fractures have an increased risk of death associated with exacerbated injury severity.

Highlights

Pelvic fracture is one of the most challenging fractures for orthopaedic and trauma surgeons to treat because of the high mortality and high frequency of the occurrence of associated injuries
The mortality of patients with pelvic ring fractures has been previously described in the literature [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]
They analyzed patients with stable fracture patterns who required on-going resuscitation and who underwent celiotomy and/or angiography, and showed that abdominal hemorrhage was responsible for hypotension in 85%, while 25% of the patients died

Summary

Introduction

Pelvic fracture is one of the most challenging fractures for orthopaedic and trauma surgeons to treat because of the high mortality and high frequency of the occurrence of associated injuries. Since pelvic ring instability is the key to determining injury severity, we hypothesized that stabilitybased Tile’s fracture type classification might be a useful predictor of patient mortality [1]. To test this hypothesis, we assessed the relationship between mortality and fracture stability using Tile’s classification together with an examination of injury severity of each patient. The purpose of this study was to determine whether instability of the pelvic ring as assessed by Tile’s classification is a predictor of death in patients with pelvic fractures. Fracture type according to Tile’s classification, and generally used traumatic parameters (injury severity score, revised trauma score, and probability of survival) were analyzed

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Conclusion