Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Clinical Characteristics of Unstable Pelvic Bone Fractures Associated with Intra-abdominal Solid Organ Injury

불안정성 골반골 골절 손상에서 동반 복부 고형장기 손상의 임상적 특성

  • Lee, Sang Won (Department of Emergency Medicine Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sun Hyu (Department of Emergency Medicine Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hong, Eun Seog (Department of Emergency Medicine Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Ahn, Ryeok (Department of Emergency Medicine Ulsan University Hospital, University of Ulsan College of Medicine)
  • 이상원 (울산대학교 의과대학 울산대학교병원 응급의학과) ;
  • 김선휴 (울산대학교 의과대학 울산대학교병원 응급의학과) ;
  • 홍은석 (울산대학교 의과대학 울산대학교병원 응급의학과) ;
  • 안력 (울산대학교 의과대학 울산대학교병원 응급의학과)
  • Received : 2011.10.17
  • Accepted : 2011.12.06
  • Published : 2012.06.30
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Abstract

Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.

Keywords

References

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