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Patterns, management, and outcomes of traumatic pelvic fracture: insights from a multicenter study.
Journal of Orthopaedic Surgery and Research ( IF 2.8 ) Pub Date : 2020-07-09 , DOI: 10.1186/s13018-020-01772-w
Husham Abdelrahman 1 , Ayman El-Menyar 2, 3 , Holger Keil 4 , Abduljabbar Alhammoud 5 , Syed Imran Ghouri 5 , Elhadi Babikir 5 , Mohammad Asim 2 , Matthias Muenzberg 4 , Hassan Al-Thani 6
Affiliation  

Traumatic pelvic fracture (TPF) is a significant injury that results from high energy impact and has a high morbidity and mortality. We aimed to describe the epidemiology, incidence, patterns, management, and outcomes of TPF in multinational level 1 trauma centers. We conducted a retrospective analysis of all patients with TPF between 2010 and 2016 at two trauma centers in Qatar and Germany. A total of 2112 patients presented with traumatic pelvic injuries, of which 1814 (85.9%) sustained TPF, males dominated (76.5%) with a mean age of 41 ± 21 years. In unstable pelvic fracture, the frequent mechanism of injury was motor vehicle crash (41%) followed by falls (35%) and pedestrian hit by vehicle (24%). Apart from both extremities, the chest (37.3%) was the most commonly associated injured region. The mean injury severity score (ISS) of 16.5 ± 13.3. Hemodynamic instability was observed in 44%. Blood transfusion was needed in one third while massive transfusion and intensive care admission were required in a tenth and a quarter of cases, respectively. Tile classification was possible in 1228 patients (type A in 60%, B in 30%, and C in 10%). Patients with type C fractures had higher rates of associated injuries, higher ISS, greater pelvis abbreviated injury score (AIS), massive transfusion protocol activation, prolonged hospital stay, complications, and mortality (p value < 0.001). Two-thirds of patients were managed conservatively while a third needed surgical fixation. The median length of hospital and intensive care stays were 15 and 5 days, respectively. The overall mortality rate was 4.7% (86 patients). TPF is a common injury among polytrauma patients. It needs a careful, systematic management approach to address the associated complexities and the polytrauma nature.

中文翻译:

外伤性骨盆骨折的模式,处理和结果:来自多中心研究的见解。

创伤性骨盆骨折(TPF)是高能量冲击导致的重大伤害,发病率和死亡率高。我们旨在描述跨国公司1级创伤中心的TPF的流行病学,发病率,模式,管理和结果。我们对卡塔尔和德国两个创伤中心在2010年至2016年间所有TPF患者进行了回顾性分析。共有2112例骨盆外伤患者,其中1814例(85.9%)患有TPF,男性占主导地位(76.5%),平均年龄为41±21岁。在不稳定的骨盆骨折中,受伤的常见机制是机动车碰撞(41%),然后摔倒(35%)和行人撞车(24%)。除四肢外,胸部(37.3%)是最常见的受伤区域。平均损伤严重程度评分(ISS)为16.5±13.3。观察到44%的血流动力学不稳定。三分之一需要输血,而十分之一和四分之一的病例分别需要大量输血和重症监护。1228例患者可以进行图块分类(A型为60%,B型为30%,C型为10%)。C型骨折患者的相关伤害发生率更高,ISS更高,骨盆缩写损伤评分(AIS)更高,大量输血方案激活,住院时间延长,并发症和死亡率较高(p值<0.001)。三分之二的患者保守治疗,三分之一的患者需要手术固定。住院和重症监护病房的中位时间分别为15天和5天。总死亡率为4.7%(86名患者)。TPF是多发伤患者的常见伤害。需要小心一点
更新日期:2020-07-09
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