The relationship between pelvic (ring and acetabulum) fractures and organ injuries

Aim Our aim in this study was to evaluate patient outcomes resulting from the follow-up and treatment of pelvic cavity fractures and their common accompanying organ injuries. Introduction Disruption of pelvic ring continuity is a devastating injury commonly associated with neurovascular, gastrointestinal, and urogenital injuries. The aim of this study was to determine whether instability of the pelvic ring, as assessed by Young–Burgess classification, was a predictor of intra-abdominal/intra-thoracic (IAIT) injury rate in patients with pelvic fractures. Patients and methods In total, 216 patients with pelvic cavity fractures were included in the study. All patients were evaluated retrospectively according to age, gender, injury mechanism, imaging modalities (fracture types), blood transfusions, additional organ injuries, instability of the pelvic ring, abbreviated injury scale (AIS) and injury severity score (ISS) values, hospitalization, and follow-up time. Results Trauma mechanisms were separated into low and high energy; 153 (70.8%) patient injuries had low-energy and 63 (29.1%) had high-energy mechanisms. In terms of the region that developed symptoms after the trauma event, 28 (12.4%) patients had IAIT injury, 24 (10.6%) had urological, and seven had (3.2%) intra-cranial trauma symptoms. Patients with IAIT injuries were mostly associated with Young lateral compression fractures (n = 11; 5%), and transverse acetabular fractures (n = 4; 1.8%), seen in equal proportion with anterior acetabular column fractures. In patients with intra-abdominal/intra-thoracic injuries, the high-energy trauma rate was 92%, and in patients with pelvic fracture, the rate was 19%. In patients with IAIT injuries, scores on the AIS and ISS were significantly higher than in other patients with pelvic fracture. Discussion We investigated fracture type and severity of injury in relation to IAIT injuries. We detected significant levels of Young lateral compression fractures, 5%, and acetabular transverse fractures, 1.8%, in relation to intraabdominal/ intra-thoracic injuries.