O3342 UNSTABLE PELVIC FRACTURE MANAGEMENT IN MULTIPLE INJURIED PATIENTS

Abstract

Aims: To evaluate need for fast and correct diagnosis of pelvic fracture. Correlation of plain (AP) pelvic X-ray and and mortality and resultant necessity of emergency pelvic external þxation. Methods: We performed retrospective analysis of 152 patients with mechanically unstable pelvic fractures treated in period of 1996–2000. Observed pelvic ring fractures were type B1, B2 or C (and its subcroups) according to classiþcation of Tile, modiþed by Kellam and Browner. All of them (152) had at least two body regions injurie and ISS> 17 (mean ISS=29.2). 79 (52%) patients were haemodynamically unstable at admission.

Parameters examined were as follows: injury severity, fracture type, hemodynamics at admission, time to and device of þxation, mortality. Results: Signiþcant differece was found in mortality in different fracture types: B1 11.1%, B2 Ð 5.6%, C Ð 37.5%. Also, a marked difference was seen in haemodynamic instability in different fracture types: B1- 55,5%, B2 Ð 20%, C Ð 73,6%. Mean injury severity scores: B1 -30,6 B2 -30,0 C Ð32,0. The need for emergency pelvic þxation was B1 Ð 44%, B2 Ð 5,6%, C Ð 42,4%, mostly AO tubular Ex. Fix was used. The study showed obvious correlation between the type of pelvic fracture and mortality. Conclusion: In pelvic fractures correct and fast diagnosis should be made in emergency room by plain AP x-ray. We found Tile pelvic fracture classiþcation to correlate patients haemodynamical state and guide fracture management and to be important prognostic criteria. Pelvic fracture which leads to increase of pelvic volume (B1, C) is prognostically worse and has higher mortality.