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pelvic fracture
Etiology:
1) motor vehicle accidents (77%)
2) falls, especially falls in the elderly (19%)
Epidemiology:
1) mean age 31 years (wide range)
2) 77% males
Laboratory:
- see osteoporotic fracture as indicated (falls in the elderly)
Radiology:
- x-ray of pelvis (image) [2]
- also see osteoporotic fracture as indicated (falls in the elderly)
Complications:
- death predicted by associated injuries, not fracture instability [1]
- 1/3 of patients with hemodynamically unstable pelvic fractures die [3]
Management:
- for hemodynamically unstable pelvic fractures, only pelvic angioembolization is associated with reduced mortality (RR= 0.62) [3]
Specific
acetabular fracture
pelvic insufficiency fracture
General
bone fracture
References
- Lunsjo K et al,
Associated injuries and not fracture instability predict
mortality in pelvis fractures: A prospective study of 100
patients.
J Trauma 2007, 62:687
PMID: 17414348
- Tai TH, Chen CY
Images in Clinical Medicine: Open-Book Pelvic Fracture.
N Engl J Med 2021; 384:60. Jan 7.
PMID: 33406331
https://www.nejm.org/doi/full/10.1056/NEJMicm2013030
- Anand T, El-Qawaqzeh K, Nelson A et al
Association Between Hemorrhage Control Interventions and Mortality in US Trauma
Patients With Hemodynamically Unstable Pelvic Fractures.
JAMA Surg. Published online Nov 30, 2022.
PMID: 36449300
https://jamanetwork.com/journals/jamasurgery/fullarticle/2799004