Analysis of Combined Pelvic Ring and Acetabulum Fractures for their Optimal Management
Senthil Kumar Selvarajan*, Inder Gill, Nikil Shah, Vineet Trivedi, Ahmed Galhoum and Tanya Tradoff
Department of T and O, George Eliot Hospital NHS, UK
*Corresponding Author: Senthil Kumar Selvarajan, Department of T and O, George Eliot Hospital NHS, UK.
April 27, 2021; Published: May 20, 2021
Background: Pelvic fractures carry a huge burden on the current health care system and it has a high morbidity and mortality. The survivors carry a huge burden of complications which can have a lifetime implication, it is therefore imperative to understand the fracture pattern and plan for appropriate care which could be a key in optimal care of these critically injured patient. The classical classification system used for these fractures need to be adapted according to the mechanism of injury and severity of trauma which should also guide in decision making process.
Methods: In this retrospective study all pelvic trauma patients who attended Salford royal NHS foundation from 2015 to 2018 were retrieved then the patterns of fractures and mechanism of injury were analysed and correlated.
Results: Combined pelvic ring and acetabular fractures  can be sub-categorised into three groups according to mechanism of injury and fracture patterns:
- Type 1: Road traffic collision causes fracture involving anteroposterior compression (APC) 1, 2, 3 along with Anterior wall (AW), Anterior Column (AC), associated both columns (ABC) variety, lateral compression fractures are rare in RTC, hemodynamic stability is dependent of grade of APC than acetabular fracture pattern and treatment can vary from non-operative to complex surgeries.
- Type 2: Jumpers commonly sustain lateral compression (LC) and ABC pattern and have high Injury severity score (ISS) when compared to RTC, majority of them are hemodynamically unstable and require blood products and more often end up in a broad spectrum of pelvic surgery. Mortality rate is high, and we found nearly 30% of them die within 24 hours in our study.
- Type 3: Cyclers and pedestrians have an equal incidence of type 1 and type 2 fractures and rarely presents with a combination of type 1 and 2. ISS, blood transfusion and mortality are like type 1 and type 2 combined fractures and treatment must be designed after a thorough understanding of fracture types. Often require complex surgery.
Keywords: Anteroposterior Compression (APC); Anterior Wall (AW); Anterior Column (AC); Associated Both Columns (ABC); Lateral Compression (LC); Injury Severity Score (ISS)
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