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May 1983

Major Pelvic Fractures

Author Affiliations

From the Departments of Surgery (Drs Naam, Brown, Hurd and Kaminski) and Orthopedics (Dr Burdge) and the Surgical Intensive Care Unit (Dr Kaminski), St Louis University Medical Center.

Arch Surg. 1983;118(5):610-616. doi:10.1001/archsurg.1983.01390050076015

• Pelvic fractures associated with blunt trauma contributed significantly to morbidity and mortality in 593 patients with high-velocity deceleration injuries. Those with open, hemorrhagic pelvic fractures required massive blood volume replacement and intensive care for long periods of time and had a 60% mortality. Patients with hemorrhagic pelvic fractures also had a notable blood replacement requirement (mean, 29 units) and a 50% mortality. Patients with open pelvic fractures without significant hemorrhage had a 25% mortality and were at an increased risk of pelvic sepsis. The overall mortality associated with pelvic fractures following high-velocity deceleration accidents was 16.6%. The identifiable causes of death in patients with pelvic fractures were associated injuries, particularly closed head injury, hemorrhage from pelvic vessels, and sepsis. An improved survival rate requires better, more prompt use of available treatment, as well as development of new and better methods of caring for severely injured patients with blunt trauma.

(Arch Surg 1983;118:610-616)