ANGIOGRAPHIC FINDINGS IN PELVIC FRACTURES

Pelvic fractures are high energy injuries indicative of significant tr auma, Hypotension and significant blood loss is common in skeletally u nstable pelvic fractures, Potential sites of intrapelvic bleeding incl ude fractured bone edges, venous injuries and/or arterial vascular inj uries, In an attempt to define the relationship of fracture pattern to arterial injury, a specific subset of 39 patients with pelvic fractur es who underwent angiography for hemodynamic instability or ongoing bl ood loss were reviewed retrospectively. In 35 patients with definable arterial injuries, 20 (57%) had multiple bleeding sites, Posterior art erial bleeding (internal iliac or its posterior branches) was statisti cally more common in patients with unstable posterior pelvic fractures , and anterior arterial bleeding (pudendal or obturator) was more comm on in patients with lateral compression injuries, The pudendal artery was the most commonly injured vessel in this series, The superior glut eal artery was the most commonly injured vessel associated with poster ior pelvic fractures, There was no correlation between fracture patter n and survival, The injury severity score however, did indirectly corr elate to survival, In addition, the presence of hypotension (systolic blood pressure less than or equal to 90) at the time of arrival to the trauma center was found to significantly increase mortality.