UNSTABLE PELVIC FRACTURES - A RETROSPECTIVE ANALYSIS

Thirty-nine patients with unstable pelvic fractures were analysed retr ospectively. The mean age of the group was 41 years (range 15-77). Of these cases 35 had sustained high energy trauma. The mean Hospital Tra uma Index-lnjury Severity Score of the population was 32 (16-66). Nine cases were haemodynamically unstable on admission. The type of unstab le pelvic fracture was classified according to Tile. Sixteen patients had a type B fracture and 23 had a vertical instability (type C) fract ure. In two patients, an open fracture was seen. Directly associated i njuries were diagnosed in 11 patients, of which eight showed damage of the urogenital system, three of the rectum and three of the periphera l nerve system. In seven cases the fracture was treated non-operativel y; in the remaining 32 patients the pelvic ring was stabilized operati vely. Additional therapy Jar hypovolaemic shock due to pelvic bleeding was necessary in six cases. The overall mortality in this series was 13 per cent. Early and aggressive resuscitation and standardized treat ment in well-equipped and staffed injury centres is mandatory in these severely traumatized patients to achieve optimal results and to minim ize the risk of fatal outcome.