Pelvic ring fractures undergoing definitive treatment: Experience of a level 1 trauma center

Introduction: Pelvic ring fracture is rare, accounting for only 3% of skeletal fractures but is associated with hogh mortality, usually due hemorrhagic shock. Management consists of resuscitation and pelvic stabilization.

Objectives: To present the experience and outcomes of surgical treatment of pelvic ring fractures at a level 1 trauma center.

Materials and Methods: A retrospective analysis was conducted on all patients who underwent definitive treatment for pelvic ring fractures by the same surgical team in our facility between May 2021 and July 2023. Demographic data, type of accident, fracture classification (Young-Burgess), associated injuries, surgical interventions, requirement for blood transfusion and Majeed"s Score at 1 year were analyzed. Three degrees of instability were defined (stable fracture, partially unstable, and unstable).

Results: A total of 23 patients were included (20 males / 3 females), with an average age of 55±17 years. Motorcycle accident was the most common cause (34%), followed by fall from height (26%). The most prevalent fracture type was APC II (39%). Increased mechanical instability was associated with increase in associated injuries 5 (4-8). Transfusion needs also increased with instability, with an average of 5.71±3.91 units in patients with unstable fractures. Patients with unstable fractures initially treated with external fixation (n=4) required fewer transfusions on average 4.0±3.8 than those who did not undergo external fixation 8.0±4.1 (n=3). The median time to weight-bearing was 7 days. The Majeed"s Score at 1 year was evaluated in 16 patients with an average of 85.6±10.5.

Conclusions: Pelvic ring fracture is a rare condition often associated with secondary injuries. A multidisciplinary approach to these types of injuries using evidence-based protocols appears to yield favorable results.

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