Background: Common and external iliac artery injuries associated with pelvi
c fractures are uncommon. The diagnosis of such injuries is based on clinic
al findings and confirmed by arteriography.
Design: Retrospective chart review.
Setting: University Level I trauma center.
Patients: Five men and three women, aged seventeen to seventy-six years, wi
th injuries to the common and external iliac arteries associated with pelvi
c fractures.
Results: All patients sustained complex pelvic fractures associated with mu
ltiple blunt injuries. Five injuries occurred on the right side. Two patien
ts had an associated right vertical shear pelvic fracture. In five patients
, vascular injury was diagnosed in the first six hours after admission. One
patient presented with an aneurysm of the right common iliac artery two mo
nths after his initial injury: All patients underwent surgical repair with
an interposition graft, which failed in two patients, who underwent vascula
r reconstruction ten hours after the injury. One patient died of associated
injuries.
Conclusions: Arterial hyperextension with intimal damage seems to be the mo
st likely cause of this injury. Ideally, an extraperitoneal approach should
be attempted to minimize blood losses and, due to the size of the iliac ve
ssels, an interposition graft should be used for reconstruction.