Abstract
Background
Open pelvic fractures occur uncommonly. Despite serious sequelae, they have been infrequently
reviewed.
Methods
We conducted a retrospective review of all patients with open pelvic fractures in
our department from January 2001 to April 2010.
Results
Forty-one patients (32 men, 9 women) with these injuries were identified. The average
Injury Severity Score (ISS) was 31.4, with 80% of patients having a score ≥16. The
average blood transfusion in the first 24 h was 17.2 units, and the average hospital stay was 60 days. Overall mortality was 24%(n = 10): 3 early deaths and 7 late deaths. Factors associated with overall mortality by
univariate analysis were ISS, RTS, GCS, age, pelvic sepsis, Gustilo classification
of soft-tissue injury, and Young classification of bony fracture. Factors associated
with late mortality by univariate analysis were: ISS, RTS, pelvic sepsis, Gustilo
classification of soft-tissue injury, and blood transfusion in the first 24 h. Moreover, multivariate analysis showed that only RTS was independently associated
with both overall and late mortality.
Conclusion
Despite treatment advances, mortality rates remain high in patients with open pelvic
fractures. The urogenital and/or intra-abdominal injuries are not associated with
mortality. RTS ≤ 8 might be a predictor of poor outcome in open pelvic fractures patients. Open reduction
and internal fixation might be used in those unstable pelvic fractures without gross
contamination in the fracture region after extensive cleansing and lavage. More emphasis
needs to be placed on this injury complex.
Keywords
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Article info
Publication history
Accepted:
January 31,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
