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Journal Articles Orthopaedics & Traumatology: Surgery & Research Year : 2016

Pelvic fracture in multiple trauma: A 67-case series


Introduction: Severe pelvic trauma remains associated with elevated mortality, largely due to hemorrhagic shock. Objective: The main study objective was to test for correlation between fracture type and mortality. The secondary objective was to assess the efficacy in terms of mortality of multidisciplinary management following a decision-tree in multiple trauma victims admitted to a level 1 trauma center. Material and methods: Between July 2011 and July 2013, 534 severe trauma patients were included in a single-center continuous prospective observational study. All patients with hemorrhagic shock received early treatment by pelvic binder. Patients with active bleeding on full-body CT or persisting hemorrhagic shock underwent arteriography with or without embolization. Pelvic trauma was graded on the Tile classification. The principle end-point was mortality. Results: Median age was 40 years (range, 26-48 years), with a 79% male/female sex ratio. Thirty-two of the 67 patients with pelvic trauma (48%) were in hemorrhagic shock at admission. Median injury severity score (ISS) was 36 (range, 24-43). On the Tile classification, 22 patients (33%) were grade A, 33 (49%) grade B and 12 (18%) grade C. Overall mortality was 19%, and 42% in case of hemorrhagic shock. Mortality was significantly higher with Tile C than A or B (58% vs. 9.1% and 12.1%, respectively; P = 0.001). Conclusion: Vertical shear fracture (Tile C) was associated with greater mortality from hemorrhagic shock. (C) 2016 Elsevier Masson SAS. All rights reserved.

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hal-01453314 , version 1 (02-02-2017)



M. Caillot, E. Hammad, M. Le Baron, V. Villes, M. Leone, et al.. Pelvic fracture in multiple trauma: A 67-case series. Orthopaedics & Traumatology: Surgery & Research, 2016, 102 (8), pp.1013-1016. ⟨10.1016/j.otsr.2016.08.018⟩. ⟨hal-01453314⟩
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