Related Experiment Video
Updated: Aug 14, 2026
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
The outcome of open pelvic fractures in the modern era
Christopher J Dente1, David V Feliciano, Grace S Rozycki
1Emory University, Grady Memorial Hospital, 69 Jesse Hill Dr., Atlanta, GA 30303, USA. cdente@emory.edu
Insights
Open pelvic fractures have a high mortality rate, especially with associated intra-abdominal injuries or arterial bleeding. New treatments are needed for this severe trauma complex.
Area of Science:
- Trauma Surgery
- Orthopedic Surgery
- Emergency Medicine
Background:
- Open pelvic fractures are severe injuries.
- Previous reports indicate <10% mortality, but associated intra-abdominal damage's significance is unclear.
Purpose of the Study:
- To evaluate the prognostic significance of intra-abdominal visceral damage in open pelvic fractures.
- To identify risk factors for mortality in open pelvic fractures.
Main Methods:
- Retrospective review of patients with open pelvic fractures from 1995-2004 at an urban level I trauma center.
- Analysis of mortality rates and associated injuries.
Main Results:
- 44 patients with open pelvic fractures had a 45% overall mortality rate.
- Intra-abdominal injury conferred an 89% mortality rate.
- Vertical shear injuries were universally fatal; pelvic sepsis led to late deaths.
Conclusions:
- Morbidity of open pelvic fractures remains high.
- Intra-abdominal injury and arterial bleeding requiring angiography indicate a poor prognosis.
- Novel therapeutic strategies are necessary for managing these complex injuries.
Background:
Recent series have reported that the mortality rate of open pelvic fractures has decreased to < 10%. These injuries are often associated with intra-abdominal visceral damage, although few series have documented the prognostic significance of this injury complex.
Methods:
A retrospective review in an urban level I trauma center of all patients who sustained open pelvic fracture between 1995 and 2004.
Results:
Forty-four patients were identified as having sustained open pelvic fracture. Average Injury Severity Score was 30, with 77% of patients having a score > or = 16. Overall mortality was 45% (n = 20): 11 early deaths and 9 late deaths at an average of 17 days. Vertical shear injuries, although rare, were universally fatal. Other risk factors for overall mortality included revised trauma score, Injury Severity Score, transfusion requirement, Faringer zones I or II injury, Gustilo grade III soft tissue injury, need for therapeutic angiography, and presence of intra-abdominal injury, the latter of which conferred 89% mortality. Risk factors for late deaths also included pelvic sepsis, which occurred in 5 patients and was fatal in 3 (60%).
Conclusions:
The morbidity of open pelvic fractures remains high. Associated intra-abdominal injury or active arterial bleeding requiring therapeutic angiography is associated with a grim prognosis. There is a continuing need for new therapeutic approaches to this injury complex.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: