Where and what arteries are most likely injured with pelvic fractures? (original) (raw)
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Turkish Journal of Trauma and Emergency Surgery, 2018
BACKGROUND: In most respects, the vast majority of pelvic injuries is not of a life-threatening status, but co-presence of other injuries needs to be diagnosed. This study aims to evaluate associated pelvic and extra-pelvic visceral organ injuries of the patients with closed pelvic fractures. METHODS: This retrospective study was conducted with 471 adult patients who had been admitted to our Emergency Service with the diagnosis of pelvic fractures. Type of fractures, accompanying visceral organ injuries, the demographic data, type of operation, mortality rates were recorded and analysed statistically. RESULTS: The rate of operations carried out by the general surgery clinic or other surgical clinics in each type of fracture according to AO classification did not differ (p=0.118). In patients with A2, A3 and B1 types of fractures, the operation rate of general surgery clinic did not show a significant difference. However, most of the patients who had extrapelvic surgery were in the mild severity pelvic trauma, such as AO A2 and A3. A total of 31 patients were ex-patients, 17 of whom had AO-A2 type of fractures. The findings showed that there was a significant difference between abdominal ultrasonography outcome that was normal and non-orthopedic surgery types (p<0.001). There was no significant difference between the types of surgery performed and Abdominal CT outcome, which was normal (p=0.215). CONCLUSION: In the management of patients with pelvic fractures irrespective of its type or grade, the findings suggests that greater attention should be paid to not to overlook the associated injuries. Early blood and imaging tests are encouraged after the patient's hemodynamic status is stabilized.
Epidemiology and outcome of complex pelvic injury
Acta orthopaedica Belgica, 2005
Soft tissue injuries associated with pelvic fractures are often responsible for compromised haemodynamics. The objective of this study was to clarify what parameters determine patient outcome. In a cohort study, all patients with a pelvic fracture treated between 1991 and 2001 at a Level I trauma center were analysed for associated intrapelvic injuries, classification, severity of trauma, type of intervention and outcome. Of 552 patients with a pelvic fracture who entered the study, 15.5% presented with associated intrapelvic injuries secondary to the fracture (group I). A subgroup of patients with lacerations of branches of the iliac artery was identified as being at high risk for lethal outcome; they represented 4.3% of all patients with pelvic fracture (group II). The overall mortality reached 4.4%; it increased in group I to 15.5%, and in group II to 33.3%. In the subgroup with pelvic arterial haemorrhage (group II), the severity of injury, the proportion of multiple injured pat...
Lesions Associated with Pelvic Fracture: An Integrating Literature Review
Archives of Medicine, 2017
Objective: To review in the scientific literature the main lesions associated with pelvic fractures. Methods and Results: An integrative review was carried out in the databases: LILACS, MEDLINE, SciELO and BDENF, including national and international publications, from 2006 to 2016, obtaining a sample for analysis of nineteen articles. Pelvic fractures can have a significant impact on the genitourinary system, with some patients having a direct lesion concomitant with the urethra or bladder. The thoracic trauma resulting from pelvic fracture, among them, rib fractures, accompanied by pneumothorax and pulmonary contusion, are often associated with abdominal injuries, the organs most affected are thoracic/abdominal organs, especially bladder, spleen, liver, urethra and kidneys. Bone lesions, including fractures of the upper and lower limbs, cranial fractures are also frequently associated with pelvic trauma, as well as hematological complications, mainly thromboembolism, deep vein thrombosis and hemorrhage. Conclusion: This study made it possible to analyze the production of lesions associated with pelvic fractures. In this context, we emphasize the need for studies that also emphasize care for these patients through humanized care, in order to minimize physical discomforts and social, psychic and emotional problems that can be generated by these injuries.
Injury, 2020
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Injury, 2013
Traumatic disruptions of the pelvic ring are high energy life threatening injuries. Management represents a significant challenge, particularly in the acute setting in the presence of severe haemorrhage.
Update on the roles of angiography and embolisation in pelvic fracture
Injury, 2008
Trauma remains the leading cause of death in the younger civilian population (<44 years). Traffic accidents are 2.4 times more common among males than females. Significant differences exist between the European Union Member States, with almost five times as many deaths from trauma among the under-20s in Slovakia as in Sweden. The three countries with the lowest crude death rates from external causes among males <19 years are Sweden, the Netherlands and the UK, with 10, 11 and 12 deaths per 100,000 inhabitants, respectively. 12 Injury to the central nervous system is the leading
The outcome of open pelvic fractures in the modern era
The American Journal of Surgery, 2005
Background: Recent series have reported that the mortality rate of open pelvic fractures has decreased to Ͻ10%. 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 Ն16. Overall mortality was 45% (n ϭ 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%).
Prevalence of Pelvic Fractures, Associated Injuries, and Mortality: The United Kingdom Perspective
The Journal of Trauma: Injury, Infection, and Critical Care, 2007
Background: We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facilities in the receiving hospitals on outcome.