European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
Management and outcomes of moderate-to-severe pelvic ring fractures: a 10-year experience from an Australian Level 1 Trauma Centre.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Tay Tze Hee, Rosley Muhammad, Patel Bhavik, Wullschleger Martin
Аннотация
PURPOSE: Moderate-to-severe pelvic ring fractures are associated with high morbidity and mortality despite advances in resuscitation, development in trauma systems and multispecialty haemorrhage control. This study aimed to describe the management strategies and clinical outcomes of moderate-to-severe pelvic ring fractures over a 10-year period at an Australian Level I Trauma Centre.
METHODS: A retrospective observational cohort study was performed of patients aged ≥ 16 years with moderate-to-severe pelvic ring fractures (Abbreviated Injury Scale (AIS) ≥ 3) treated between January 2015 and December 2024. Data were obtained from the institutional prospectively collected trauma registry.
RESULTS: A total of 313 patients met the inclusion criteria. The mean age was 47.0 years and 69.3% were male. Motor vehicle (35.1%) and motorcycle collisions (24.9%) accounted for 60.1% of injuries. Median ISS was 26 (IQR 19-34), with 70.6% sustaining pelvic AIS 4-5 injuries. 20.1% of patients underwent at least one haemorrhage-control intervention, including angioembolisation (14.4%), preperitoneal pelvic packing (5.8%) and external fixation (5.8%). Angioembolisation utilisation increased from 6.7% in 2015 to 40.0% in 2024. In-hospital mortality was 7.7%, with traumatic brain injury accounting for 62.5% of deaths and haemorrhagic shock for only one death.
CONCLUSION: Moderate-to-severe pelvic ring fractures remained characterised by high-energy mechanisms and severe multisystem injury over the study period, while management evolved with increasing utilisation of angioembolisation. In-hospital mortality was numerically lower compared with historical cohorts, with most deaths attributable to associated traumatic brain injury rather than pelvic haemorrhage.
METHODS: A retrospective observational cohort study was performed of patients aged ≥ 16 years with moderate-to-severe pelvic ring fractures (Abbreviated Injury Scale (AIS) ≥ 3) treated between January 2015 and December 2024. Data were obtained from the institutional prospectively collected trauma registry.
RESULTS: A total of 313 patients met the inclusion criteria. The mean age was 47.0 years and 69.3% were male. Motor vehicle (35.1%) and motorcycle collisions (24.9%) accounted for 60.1% of injuries. Median ISS was 26 (IQR 19-34), with 70.6% sustaining pelvic AIS 4-5 injuries. 20.1% of patients underwent at least one haemorrhage-control intervention, including angioembolisation (14.4%), preperitoneal pelvic packing (5.8%) and external fixation (5.8%). Angioembolisation utilisation increased from 6.7% in 2015 to 40.0% in 2024. In-hospital mortality was 7.7%, with traumatic brain injury accounting for 62.5% of deaths and haemorrhagic shock for only one death.
CONCLUSION: Moderate-to-severe pelvic ring fractures remained characterised by high-energy mechanisms and severe multisystem injury over the study period, while management evolved with increasing utilisation of angioembolisation. In-hospital mortality was numerically lower compared with historical cohorts, with most deaths attributable to associated traumatic brain injury rather than pelvic haemorrhage.