Trauma to the pelvis and extremities

Abstract

Pelvic fractures account for 3% to 8% of all skeletal injuries.1-3 Two distinct patient populations sustain pelvic fractures: those involved in high-energy trauma, frequently motor vehicle or pedestrian versus motor vehicle collisions, and those who sustain a low-energy event, commonly an elderly patient with osteoporosis who sustains a fall resulting in a pelvic fracture with a stable pelvic ring and minimal concomitant injuries. High-energy mechanisms are involved in 13 % to 18 % of all pelvic fractures1,4 and are often accompanied by bony pelvic instability and severe soft tissue injuries, both locally and in remote systems. Injuries to the genitourinary and gastrointestinal system as a direct result of a pelvic fracture are frequent.5-7 Despite advances in organized trauma systems and intensive care, these fractures continue to present treatment dilemmas acutely and are a major source of morbidity and of mortality, which ranges from 7% to 50%.4,5,8-13 Appropriate assessment and management by a multidisciplinary team are crucial to maximize the chance of survival of these patients and their return to preinjury function. © 2008 Springer New York.