Morbidity associated with isolated iliac wing fractures

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Radiology

Background:

• Iliac wing fractures are infrequently documented, often resulting from direct impact.
• These fractures are typically stable but carry risks of significant soft tissue, abdominal, and vascular damage.

Purpose of the Study:

• To investigate the incidence, radiographic features, associated soft tissue injuries, and complications of isolated iliac wing fractures.

Main Methods:

• A retrospective review of 450 polytraumatized patients from 2003-2006 at a level-1 trauma center.
• Analysis of hospital records and radiographs; clinical and radiologic re-examination of patients with isolated iliac wing fractures.

Main Results:

• Ten patients had isolated iliac wing fractures, all from high-energy trauma.
• Nine patients had 36 associated injuries across multiple systems (head, thorax, spine, abdomen, urologic, orthopedic).
• Operative fixation was rare; nonoperative management was common, with surgical intervention for bowel compression or large displaced fragments.

Conclusions:

• Isolated iliac wing fractures may appear benign but necessitate thorough investigation for associated, potentially life-threatening injuries.
• Associated injuries may require immediate abdominal, vascular, or neurologic surgery.
• Nonoperative management is suitable for most iliac wing fractures without pelvic ring instability.