title: Early embolization without external fixation in pelvic trauma.
abstract: OBJECTIVE
  In this retrospective study, we reviewed our protocol consisting of early embolization without acute external fixation in patients with pelvic fracture.
  
  
  METHODS
  Eighty-eight patients with pelvic fracture were identified by reviewing the records of the Fukui Prefectural Hospital from April 2005 through September 2009. We managed the patients with a treatment protocol consisting of hemodynamic resuscitation and early pelvic embolization. Patients with hemodynamic instability without nonpelvic hemorrhage or extravasation of contrast in the pelvis by computed tomography (CT) were indicated to angiography and embolization. External fixation of the pelvic ring was not used in our protocol.
  
  
  RESULTS
  Of the 88 patients with pelvic fractures, 43 underwent angiography. Twenty-eight patients (65%) were hemodynamically unstable. Twenty-five patients (58%) had major ligamentous disruption. Computed tomography detected extravasation in 21 patients (48%). Of the 43 patients who underwent angiography, 29 (67%) were positive. The average time from hospital arrival to angiography was 76.3 ± 34.5 minutes. The packed red blood cell requirement in the initial 24 hours was 8.4 ± 8.2 U, required in the embolization group. There was no complication-related embolization. Repeat angiography was not required in all patients. The mortality rate of patients requiring angiography was 11%.
  
  
  CONCLUSIONS
  Early pelvic embolization without external fixation may be useful for the initial treatment for patients with hemodynamic instability without nonpelvic hemorrhage or with extravasation of contrast in the pelvis by CT.
authors.affiliation: Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui 910-8526, Japan. sytanizak@yahoo.co.jp
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Tanizaki
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Maeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Matano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishida
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: Toru
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000792:Angiography / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D042241:Early Diagnosis; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D058734:Exsanguination / Q000628:therapy; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000628:therapy*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D010388:Pelvis / Q000098:blood supply; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed