title: Early versus delayed fixation of pelvic ring fractures.
abstract: This retrospective study reports outcomes, after early and delayed surgical stabilization of fractures of the pelvic ring, in terms of pulmonary complications, length of hospital stay, and cost of hospitalization. The hospital course of 151 patients admitted to an academic teaching hospital who sustained acute fractures of the pelvic ring between June 1996 and December 2000 was reviewed. Patient demographics, Injury Severity Score (ISS), timing of operative fixation, and the incidence of pulmonary complications were analyzed. Radiographs were reviewed and fractures classified according to the modified Tile system. Tile fracture types B and C patients who underwent fixation within 1 week of injury (n = 71) were compared to those in whom surgery was delayed (n = 28). Adjusting for the ISS, early-repair patients had a lower risk of pulmonary complications (RR = 0.49, 95% CI = 0.25-0.96), a reduced length of hospital stay (12.2 vs. 20.5 days; P = 0.0005), and overall reduced cost of care (57,084 dollars vs. 158,625 dollars; P = 0.0317). Pelvic ring fixation within the first week of injury results in significantly reduced incidence of pulmonary complication, hospital stay, and cost of care regardless of injury severity. The coordinated team approach to insure prompt resuscitation, stabilization, and operative fixation results in more optimal patient outcomes.
authors.affiliation: Section of Orthopaedic Trauma, Division of Orthopaedic Surgery, Department of Surgery, School of Medicine, University of Alabama at Birmingham, 35294-0016, USA.
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Connor
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Paul A
authors.initials: PA
authors.lastname: MacLennan
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Alonso
authors.forename: Loring W
authors.initials: LW
authors.lastname: Rue
mesh_terms: D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000191:economics / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008171:Lung Diseases / Q000517:prevention & control; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome