Major pelvic fractures
N. H. Naam, W. H. Brown, R. Hurd, R. E. Burdge and D. L. Kaminski
Pelvic fractures associated with blunt trauma contributed significantly to
morbidity and mortality in 593 patients with high-velocity deceleration
injuries. Those with open, hemorrhagic pelvic fractures required massive
blood volume replacement and intensive care for long periods of time and
had a 60% mortality. Patients with hemorrhagic pelvic fractures also had a
notable blood replacement requirement (mean, 29 units) and a 50% mortality.
Patients with open pelvic fractures without significant hemorrhage had a
25% mortality and were at an increased risk of pelvic sepsis. The overall
mortality associated with pelvic fractures following high-velocity
deceleration accidents was 16.6%. The identifiable causes of death in
patients with pelvic fractures were associated injuries, particularly
closed head injury, hemorrhage from pelvic vessels, and sepsis. An improved
survival rate requires better, more prompt use of available treatment, as
well as development of new and better methods of caring for severely
injured patients with blunt trauma.
