Improved outcome with early fixation of skeletally unstable pelvic fractures.
Thirty-seven consecutive patients with unstable pelvic fractures were divided into two groups: Group 1 (July 1981 to December 1984; n = 18), when early fixation was not routinely used, and Group 2 (January 1985 to March 1988; n = 19), when early fixation was performed unless contraindicated. Hospital stay decreased by 37.8% in Group 2 (p = 0.04). Of Group 1 patients, 60% were disabled for at least 6 months versus 15.7% in Group 2 (p = 0.001), and 45% were discharged to a rehabilitation facility versus 26.4% in Group 2. Group 1 had more complications, 1.3 per patient, versus 1.0. Patients in Group 2 (undergoing early fixation) required 27.2% fewer units of blood than those in Group 1 in whom fracture surgery was delayed. Survival was better in Group 2, 100% versus 83.3% (p = 0.06). Early pelvic fracture fixation reduces hospital stay, long-term disability, and may result in fewer complications, decreased blood loss, and better survival.
Latenser
B A
BA
Department of Surgery, University of Nevada School of Medicine, Las Vegas.
Gentilello
L M
LM
Tarver
A A
AA
Thalgott
J S
JS
Batdorf
J W
JW
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D009104:Multiple Trauma / Q000473:pathology; D010043:Outcome and Process Assessment, Health Care; D010384:Pelvic Bones / Q000293:injuries*; D013997:Time Factors