Pelvic fracture in multiple trauma: A 67-case series

Area of Science:

• Trauma Surgery
• Orthopedic Surgery
• Emergency Medicine

Background:

• Severe pelvic trauma is a critical condition associated with high mortality rates, primarily due to hemorrhagic shock.
• Effective management strategies are crucial for improving outcomes in patients with severe pelvic injuries.

Purpose of the Study:

• To investigate the correlation between pelvic fracture type and patient mortality.
• To evaluate the effectiveness of a multidisciplinary management approach, guided by a decision-tree, for multiple trauma victims with pelvic injuries.

Main Methods:

• A prospective observational study included 534 severe trauma patients over two years.
• Pelvic trauma was classified using the Tile classification system.
• Management involved early pelvic binder application for hemorrhagic shock, with arteriography and embolization for active bleeding.

Main Results:

• Of 67 patients with pelvic trauma, 48% presented with hemorrhagic shock.
• Overall mortality was 19%, rising to 42% in cases of hemorrhagic shock.
• Mortality was significantly higher for Tile C fractures (58%) compared to Tile A (9.1%) and Tile B (12.1%).

Conclusions:

• Vertical shear fractures (Tile C) are strongly associated with increased mortality from hemorrhagic shock.
• Fracture classification is a critical factor in predicting mortality in severe pelvic trauma.
• Multidisciplinary management may improve outcomes in these complex cases.