Open pelvic fractures. A multicenter retrospective analysis.
A marked discrepancy exists in the reported mortality rates in patients with open pelvic fractures, ranging from 4.8% to 50%. A retrospective review of patients with open pelvic fractures was performed at three centers. Thirty-nine patients with open pelvic fractures were identified; the average age was 32. The average injury-severity score was 29 (13-75). There were 10 (26%) deaths. Factors that correlated with mortality and morbidity were instability of the pelvic fracture and the presence of a rectal injury. Delay in performing diverting colostomy correlated with a poor outcome. Previously described methods of treatment are still valid; however, there is a need for re-emphasis of early diverting colostomy in the patient with a rectal or perineal injury. A classification system for open pelvic fractures is proposed in this article.
Jones
A L
AL
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Powell
J N
JN
Kellam
J F
JF
McCormack
R G
RG
Dust
W
W
Wimmer
P
P
D000328:Adult; D003125:Colostomy; D005260:Female; D005597:Fractures, Open / Q000145:classification / Q000150:complications / Q000401:mortality / Q000601:surgery; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies