Clinical Associated Factors of Tile B/C Type of Pelvic Ring Fractures; a Retrospective Cross-sectional study
Archives of Academic Emergency Medicine,
Vol. 12 No. 1 (2024),
1 January 2024
,
Page e49
https://doi.org/10.22037/aaem.v12i1.2243
Abstract
Introduction: Pelvic ring fractures categorized under Tile Categories B and C denote partially and fully unstable fractures, respectively. This study aimed to identify the clinically associated factors of Tile B/C pelvic ring fractures.
Methods: This retrospective cross-sectional study reviewed medical records from the Emergency Medicine department at Ramathibodi Hospital in Bangkok, Thailand. The study included individuals aged ≥ 15 who experienced accidents from 2012 to 2021. To investigate the associations between the clinical variables and three critical outcomes, including Tile B/C pelvic ring fractures, major vascular injuries, and the necessity for surgical or radiological interventions, multivariable logistic regression analysis was employed.
Results: A total of 198 patients were included in the study, among whom 34.8% were diagnosed with Tile B/C pelvic ring fractures. The analysis revealed several significant predictors of Tile B/C fractures, including the presence of pelvic tenderness (adjusted odds ratio [aOR] = 15.25, 95% confidence interval [CI] = 5.86-39.66, p < 0.001), and a shock index (SI) ≥1 (aOR = 4.2, 95% CI = 1.24-14.22, p = 0.021). Moreover, Tile B/C pelvic ring fractures were associated with an increased incidence of major vascular events and the imperative requirement for surgical or radiological interventions.
Conclusion: Clinical findings of pelvic tenderness and an SI ≥1 are strong predictive clinical factors associated with Tile B/C pelvic fractures. Early diagnosis, application of an pelvic binder, provision of initial resuscitation, and prompt transportation to a definitive care facility are crucial components of management.
- Factors
- Predictors
- Tile B/C
- fractures
- trauma
- Pelvic
- injury
How to Cite
References
Rinne, P.P., et al., The incidence of pelvic fractures and related surgery in the Finnish adult population: a nationwide study of 33,469 patients between 1997 and 2014. Acta Orthop, 2020. 91(5): p. 587-592.
Andrich, S., et al., Epidemiology of Pelvic Fractures in Germany: Considerably High Incidence Rates among Older People. PLoS One, 2015. 10(9): p. e0139078.
Kannus, P., et al., Low-Trauma Pelvic Fractures in Elderly Finns in 1970-2013. Calcif Tissue Int, 2015. 97(6): p. 577-80.
Verbeek, D.O., et al., Pelvic fractures in the Netherlands: epidemiology, characteristics and risk factors for in-hospital mortality in the older and younger population. Eur J Orthop Surg Traumatol, 2018. 28(2): p. 197-205.
Balogh, Z., et al., The epidemiology of pelvic ring fractures: a population-based study. J Trauma, 2007. 63(5): p. 1066-73; discussion 1072-3.
Holstein, J.H., et al., [Influence of the pelvic trauma registry of the DGU on treatment of pelvic ring fractures]. Unfallchirurg, 2016. 119(6): p. 475-81.
Forssten, M.P., et al., Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality. Trauma Surg Acute Care Open, 2022. 7(1): p. e000962.
Ramser, M., et al., The impact of specific fracture characteristics of low-energy fractures of the pelvis on mortality. BMC Geriatr, 2022. 22(1): p. 669.
Gundel, O., et al., Postoperative mortality after a hip fracture over a 15-year period in Denmark: a national register study. Acta Orthop, 2020. 91(1): p. 58-62.
Reito, A., et al., Mortality and comorbidity after non-operatively managed, low-energy pelvic fracture in patients over age 70: a comparison with an age-matched femoral neck fracture cohort and general population. BMC Geriatr, 2019. 19(1): p. 315.
Coccolini, F., et al., Pelvic trauma: WSES classification and guidelines. World J Emerg Surg, 2017. 12: p. 5.
Oliphant, B.W., et al., American College of Surgeons Committee on Trauma verification level affects trauma center management of pelvic ring injuries and patient mortality. J Trauma Acute Care Surg, 2019. 86(1): p. 1-10.
Tile, M., Acute Pelvic Fractures: II. Principles of Management. J Am Acad Orthop Surg, 1996. 4(3): p. 152-161.
Morales-García, D., et al., Retrospective observational study correlating traumatic pelvic fractures and their associated injuries according to the Tile classification. Cir Esp (Engl Ed), 2023. 101(8): p. 548-554.
Reiter, A., et al., Does a prehospital applied pelvic binder improve patient survival? Injury, 2024. 55(4): p. 111392.
Gottfried, A., et al., Hemorrhagic Shock in Isolated and Non-isolated Pelvic Fractures: A Registries-Based Study. Prehosp Emerg Care, 2024: p. 1-13.
Almansouri, D.H., 2nd, et al., The Role of MRI and CT Scan in Classification and Management of Pelvic Fractures: A Systematic Review. Cureus, 2024. 16(1): p. e52215.
Moeng, M.S., F. Viljoen, and S. Makhadi, The Role for Preperitoneal Pelvic Packing in Low-to-Middle-Income Countries: A 16-Year Experience at a Johannesburg Trauma Unit. World J Surg, 2023. 47(11): p. 2651-2658.
Klingebiel, F.K., et al., Standard practice in the treatment of unstable pelvic ring injuries: an international survey. Int Orthop, 2023. 47(9): p. 2301-2318.
van Leent, E.A.P., et al., Clinical Examination of the Pelvic Ring in the Prehospital Phase. Air Med J, 2019. 38(4): p. 294-297.
Zingg, T., et al., Prehospital use of pelvic circumferential compression devices in a physician-based emergency medical service: A 6-year retrospective cohort study. Sci Rep, 2020. 10(1): p. 5106.
Nau, C., et al., Falls from Great Heights: Risk to Sustain Severe Thoracic and Pelvic Injuries Increases with Height of the Fall. J Clin Med, 2021. 10(11).
Balet, L., et al., Performance Assessment of Out-of-Hospital Use of Pelvic Circumferential Compression Devices for Severely Injured Patients in Switzerland: A Nationwide Retrospective Cross-Sectional Study. J Clin Med, 2023. 12(17).
Küper, M.A., et al., Pelvic ring fractures in the elderly. EFORT Open Rev, 2019. 4(6): p. 313-320.
Forssten, M.P., et al., Adverse outcomes following pelvic fracture: the critical role of frailty. Eur J Trauma Emerg Surg, 2023. 49(6): p. 2623-2631.
Savatmongkorngul, S., et al., Mortality Rate of Trauma Patients with ESI Triage Level 1-2 Who Underwent Computerized Tomography-PANSCAN versus Conventional Computerized Tomography Scan. Open Access Emerg Med, 2021. 13: p. 457-463.
Harntaweesup, S., et al., Usefulness and outcome of whole-body computed tomography (pan-scan) in trauma patients: A prospective study. Ann Med Surg (Lond), 2022. 76: p. 103506.
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