Pelvic Trauma and Types Part 1

Pelvic Injuries:

Major pelvic injuries usually occur within the context of high-energy/impact trauma such as in RTC’s, vehicle vs pedestrian, falls from height, or crush injuries. Within low MOI context, less serious pelvic injuries can occur depending on patient factors and medical history, such as in the elderly, patients with degenerative bone disease, patients receiving radiotherapy, and so on.

Pelvic fractures occur in up to 20% of all polytrauma cases, with most pelvic injuries occurring in the age ranges of 15-30 years and in the over 60-year-olds. Pelvic fractures can be classified as stable or unstable. Stable being where there is often only one break in the pelvic ring and the broken ends of the bones line up adequately. This means there is usually little internal disruption and low/no internal bleeding. Stable fractures usually fall within the low-energy MOI context.

Unstable fractures occur when there are usually two or more breaks in the pelvic ring and the ends of the broken bones do not line up correctly and are displaced. This can cause significant disruption and severe internal bleeding. This type of fracture is more likely to occur due to a high-energy event.

Furthermore to these classifications, both stable and unstable pelvic fractures can be divided to open fractures, where bone has broken through the skin, or closed fractures, where bone has not broken through the skin.

Of studies conducted where there are pelvic fracture incidences, around 58% are stable, 22% have significant pelvic ring injury but remain stable, and 20% are unstable. As discussed above, the pelvic cavity contains many blood vessels and organs. Haemorrhage is the cause of death in 40% of all pelvic trauma cases. Specifically, to unstable pelvic fractures, haemorrhage is the cause of death in 60% of cases.