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Related Experiment Videos

Open pelvic fractures. A multicenter retrospective analysis

A L Jones1, J N Powell, J F Kellam

  • 1Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

The Orthopedic Clinics of North America
|July 1, 1997
PubMed
Summary

Open pelvic fractures have high mortality rates. Early diverting colostomy for rectal injuries and pelvic instability significantly impact patient outcomes, necessitating prompt surgical intervention.

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Area of Science:

  • Trauma Surgery
  • Orthopedic Surgery
  • Emergency Medicine

Background:

  • Open pelvic fractures present a significant clinical challenge with widely variable reported mortality rates.
  • Existing treatment protocols require re-evaluation to optimize patient outcomes.

Purpose of the Study:

  • To analyze factors influencing mortality and morbidity in open pelvic fractures.
  • To emphasize the importance of timely surgical interventions, including diverting colostomy.
  • To propose a classification system for open pelvic fractures.

Main Methods:

  • Retrospective review of 39 patients with open pelvic fractures across three trauma centers.
  • Analysis of patient demographics, injury severity scores, and treatment timelines.
  • Correlation of specific injuries and treatment delays with patient outcomes.

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Main Results:

  • The study identified a 26% mortality rate among the reviewed patients.
  • Pelvic fracture instability and the presence of rectal injuries were significantly associated with increased mortality and morbidity.
  • Delayed diverting colostomy correlated with poorer patient outcomes.

Conclusions:

  • Early diverting colostomy is crucial for patients with rectal or perineal injuries associated with open pelvic fractures.
  • Instability of the pelvic fracture is a key factor in predicting adverse outcomes.
  • A proposed classification system aims to standardize the management of open pelvic fractures.