Hemorrhage in pelvic fractures does not correlate with fracture length.
BACKGROUND
To analyze whether hematogenous marrow bleeding is the major source of hemorrhage after fractures of the pelvic ring.


METHODS



METHODS
Retrospective cohort study.


METHODS
Academic Level I trauma center.


METHODS
Three hundred seven consecutive pelvic ring injuries from January 1, 2000 to December 31, 2003 were evaluated. After exclusion for age, significant nonpelvic hemorrhage sources, and delayed transfer to this institution, 72 patients remained.


METHODS
Pelvic injuries were classified as fractures, fracture dislocations, or pure dislocations. These classifications were correlated to change in hematocrit between assumed preinjury and final hematocrit readings, correcting for blood transfused.


RESULTS
The dislocation group had a greater change in hematocrit than the fracture group (2.1%), though not statistically significant. No significant correlations were found between change in hematocrit and length of fracture lines.


CONCLUSIONS
Pelvic fracture surfaces may be sources of bleeding in pelvic injuries, but the fact that bleeding is similar in fractures and dislocations indicates fracture surfaces do not constitute the primary source. Based on our analysis one cannot reliably predict pelvic hemorrhage based on A/P radiograph assessments, such as fracture type.
Elzik
Mark E
ME
School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA. melzik@mednet.ucla.edu
Dirschl
Douglas R
DR
Dahners
Laurence E
LE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006400:Hematocrit; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies