Adult pelvic fractures; epidemiology, classification, diagnostics and treatment
Keywords:
pelvic fractures, pelvic injures, diagnostics, treatmentAbstract
Pelvis fractures create the very important medical problem because mortality rate is as high as 10 to 16 percent and about half of patients with pelvis injuries require operative treatment. This category includes pelvic ring fractures, acetabular fractures, and avulsion injuries. The majority of pelvis injuries are caused by high energy blunt trauma, include motor vehicle collisions and pedestrians struck by a motor vehicle, although elderly patients may sustain such injuries from a low energy mechanism. High energy trauma apart from pelvic fractures, increases the likelihood of concomitant injuries of pelvic viscera associated frequently with threatening hemorrhage. Physical examination, ultrasound and plane x-ray exam are used in diagnostics. Computer tomography is the gold standard for the evaluation of all hemodynamically stable patients. Pelvic fractures should be immobilized using either a sheet or a commercial pelvic binder wrapped circumferentially around the greater trochanters. In this review we discuss an issue of adult pelvic fractures with special attention paid o epidemiology, classification, diagnostics and treatment options.
Downloads
References
Dente C.J., Feliciano D.V., Rozycki G.S. et al.: The outcome of open pelvic fractures in the modern era. Am J. Surg 2005, 190, 830–5.
Grotz M.R., Allami M.K., Harwood P. et al.: Open pelvic fractures: epidemiology, current concepts of management and outcome. Injury 2005, 36, 1–13.
Hauschild O., Strohm P.C., Culemann U. et al.: Mortality in patients with pelvic fractures: results from the German pelvic injury register. J. Trauma 2008,64,449–55.
Giannoudis P.V., Grotz M.R., Tzioupis C. et al.: Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J. Trauma 2007, 63, 875–83.
Laird A., Keating J.F.: Acetabular fractures: a 16-year prospective epidemiological study. J. Bone Joint Surg Br 2005,87,969–73.
Balogh Z., King K.L., Mackay P. et al.: The epidemiology of pelvic ring fractures: a population-based study. J. Trauma 2007, 63, 1066–73.
Demetriades D., Karaiskakis M., Toutouzas K. et al.: Pelvic fractures: epidemiology and predictors of associated abdominal injuries and outcomes. J. Am Coll Surg 2002, 195, 1–10.
Kelsey J.L., Prill M.M., Keegan T.H. et al.: Risk factors for pelvis fracture in older persons. Am. J. Epidemiol 2005, 162, 879–86.
Kimbrell B.J., Velmahos G.C., Chan L.S., Demetriades D.: Angiographic embolization for pelvic fractures in older patients. Arch Surg 2004, 139, 728–3.
Smith W., Williams A., Agudelo J. et al.: Early predictors of mortality in hemodynamically unstable pelvis fractures. J. Orthop Trauma 2007, 21, 31–7.
Porter S.E., Schroeder A.C., Dzugan S.S. et al.: Acetabular fracture patterns and their associated injuries. J. Orthop Trauma 2008, 22, 165–70.
Gansslen A., Giannoudis P., Pape H.C.: Hemorrhage in pelvic fracture: who needs angiography?. Curr Opin Crit Care 2003, 9, 515–23.
Magnussen R.A., Tressler M.A., Obremskey W.T., Kregor P.J.: Predicting blood loss in isolated pelvic and acetabular high-energy trauma. J. Orthop Trauma 2007, 21, 603–7.
Salim A., Teixeira P.G., DuBose J. et al.: Predictors of positive angiography in pelvic fractures: a prospective study. J. Am Coll Surg 2008, 207, 656–62.
Aihara R., Blansfield J.S., Millham F.H. et al.: Fracture locations influence the likelihood of rectal and lower urinary tract injuries in patients sustaining pelvic fractures. J. Trauma 2002, 52, 205–8.
Denis F., Davis S., Comfort T.: Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clin Orthop Relat Res 1988, 227, 67–81.
Burgess A.R., Eastridge B.J., Young J.W. et al.: Pelvic ring disruptions: effective classification system and treatment protocols. J. Trauma 1990, 30, 848–56.
Letournel E.: Acetabulum fractures: classification and management. Clin Orthop Relat Res 1980, 151, 81–106.
Kocher M.S., Tucker R.: Pediatric athlete hip disorders. Clin Sports Med 2006, 25, 241–53.
Leggon R.E., Wood G.C., Indeck M.C.: Pelvic fractures in pregnancy: factors influencing maternal and fetal outcomes. J. Trauma 2002, 53, 796–804.
Gonzalez R.P., Fried P.Q., Bukhalo M.: The utility of clinical examination in screening for pelvic fractures in blunt trauma. J. Am Coll Surg 2002, 194, 121–5.
Duane T.M., Tan B.B., Golay D. et al.: Blunt trauma and the role of routine pelvic radiographs: a prospective analysis. J. Trauma 2002, 53, 463–8.
McCormick J.P., Morgan S.J., Smith W.R.: Clinical effectiveness of the physical examination in diagnosis of posterior pelvic ring injuries. J. Orthop Trauma 2003, 17, 257–61.
Shlamovitz G.Z., Mower W.R., Bergman J. et al.: How (un)useful is the pelvic ring stability examination in diagnosing mechanically unstable pelvic fractures in blunt trauma patients?. J. Trauma 2009, 66, 815–20.
Friese R.S., Malekzadeh S., Shafi S. et al.: Abdominal ultrasound is an unreliable modality for the detection of hemoperitoneum in patients with pelvic fracture. J. Trauma 2007, 63, 97–102.
Tayal V.S., Neilsen A., Jones A.E. et al.: Accuracy of trauma ultrasound in major pelvic injury. J. Trauma 2006, 61, 1453–7.
Obaid A.K., Barleben A., Porral D. et al.: Utility of plain film pelvic radiographs in blunt trauma patients in the emergency department. Am Surg 2006, 72, 951–4.
Kessel B., Sevi R., Jeroukhimov I. et al.: Is routine portable pelvic X-ray in stable multiple trauma patients always justified in a high technology era?. Injury 2007, 38, 559–63.
Routt M.L. Jr, Falicov A., Woodhouse E., Schildhauer T.A.: Circumferential pelvic antishock sheeting: a temporary resuscitation aid. J. Orthop Trauma 2002, 16, 45–8.
Lee C., Porter K.: The prehospital management of pelvic fractures. Emerg Med J 2007, 24, 130–3.
Krieg J.C., Mohr M., Ellis T.J. et al.: Emergent stabilization of pelvic ring injuries by controlled circumferential compression: a clinical trial. J. Trauma 2005, 59, 659–64.
Durkin A., Sagi H.C., Durham R., Flint L.: Contemporary management of pelvic fractures. Am J Surg 2006, 192, 211–23.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2010 Medical Journal of the Rzeszow University

This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.




