Comparing the predictive value of the pelvic ring injury classification systems by Tile and by Young and Burgess

Osterhoff, Georg; Scheyerer, Max J.; Fritz, Yannick; Bouaicha, Samy; Wanner, Guido A.; Simmen, Hans‐Peter; Werner, Clément M. L.

doi:10.1016/j.injury.2013.12.003

Cited by 72 publications

(41 citation statements)

References 25 publications

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“…10 Osterhoff et al compared the Tile and Young-Burgess classification systems with regard to their predictive value on mortality, resuscitation requirements, and associated injuries. 11 285 consecutive patients with pelvic ring fractures were retrospectively reviewed. The authors found no relationship between mortality and fracture pattern for both systems.…”

Section: Classificationmentioning

confidence: 99%

Pelvic ring injuries: Emergency assessment and management

Halawi

2015

Journal of Clinical Orthopaedics and Trauma

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Pelvic ring injuries are associated with significant morbidity and mortality. Understanding the anatomy of the pelvic ring is essential for accurate diagnosis and treatment. A systematic approach taking into account the mechanism of injury, physical examination, and radiographic assessment is important to quickly identify unstable pelvic disruptions and associated injuries. Because the pelvis is a ring structure, isolated pubic rami fractures on plain radiographs are unusual and should warrant careful evaluation for posterior pelvic disruption with computed tomography. Hemorrhagic shock can occur in about 10% of pelvic ring injuries. Immediate recognition and treatment of this life-threatening condition is critical in emergency management. In addition to fluid resuscitation and blood transfusion, circumferential wrapping, angiographic embolization, laparotomy with pelvic packing, and external fixation can be important life-saving adjuncts in the setting of hemodynamic instability.

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Section: Classificationmentioning

confidence: 99%

Pelvic ring injuries: Emergency assessment and management

Halawi

2015

Journal of Clinical Orthopaedics and Trauma

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“…These findings correlate with blood transfusion and total fluid resuscitation requirements. 7 During the necropsy, pelvic manipulation was performed, and the mechanism of lesion was clearly traceable, as described by the Young and Brugess classification. In these lateral compression type III lesions, the first anterior-lateral impact causes the rupture of the anterior hemi-pelvis, and continued force application is transmitted to the posterior sacroiliac complex -the pelvic ring becomes disrupted in two points, and opens, hence the name "open-book fracture".…”

Section: Discussionmentioning

confidence: 99%

The importance of pelvic ring stabilization as a life-saving measure in pre-hospital – A case report commented by autopsy

Durão

Alves

Barros

et al. 2017

Journal of Clinical Orthopaedics and Trauma

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Keywords:Unstable pelvic ring Open book pelvic fracture Hemorrhagic shock A B S T R A C T Hip fractures with unstable pelvic ring have great morbidity and mortality rates. These fractures result from high energy trauma such as falls from heights, road accidents and collapsing structures or other similar mechanisms of action. We report the case of a 63 years old man, construction worker, who stood inside a ditch during a wall construction when he was surprised by this collapse, which resulted in direct trauma to the right thigh and pelvis. The autopsy revealed diaphysis fracture of the right femur with an open book pelvic fracture with severe hemorrhagic infiltration and hematoma of the pelvic muscles without arterial injury. Bone bleeding and the vascular damage associated with disruption of the sacroiliac ligaments promote a very significant bleeding. Simple maneuvers such as sheet circumferential compression to promote pelvic ring closure are effective on stabilizing and closure of the sacroiliac joint. Hip manipulation of the fracture was performed during the necropsy to demonstrate and prove how a simple sheet contention can promote stabilization of the pelvic ring by closing the sacroiliac joints in open book fractures.

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“…In one study evaluating both systems, no statistical correlation was identified between mortality rates and classification subgroups. 31 When injuries were classified into larger subgroups -partially stable (Tile B1/B2/B3 and LC I/APC I) and unstable (Tile C1/C2/C3 and LC II/LC III/APC II/ APC III/VS/CM) -a significantly higher mortality rate was noted for unstable Young-Burgess fractures. 31 Similarly, Manson et al 30 highlighted that by dividing the Young-Burgess classification into stable and unstable types, the predictive power of the classification increased with regard to mortality, transfusion requirements and non-orthopaedic injuries.…”

Section: Classification Of High-energy Injuries To the Pelvic Ringmentioning

confidence: 98%

“…31 When injuries were classified into larger subgroups -partially stable (Tile B1/B2/B3 and LC I/APC I) and unstable (Tile C1/C2/C3 and LC II/LC III/APC II/ APC III/VS/CM) -a significantly higher mortality rate was noted for unstable Young-Burgess fractures. 31 Similarly, Manson et al 30 highlighted that by dividing the Young-Burgess classification into stable and unstable types, the predictive power of the classification increased with regard to mortality, transfusion requirements and non-orthopaedic injuries. Taking into account the inherent weaknesses of these classification systems, an individualised patient-specific approach must be employed to consider the patient's haemodynamic stability, the response to resuscitation, the mechanical stability of the pelvis and the associated injuries.…”

Section: Classification Of High-energy Injuries To the Pelvic Ringmentioning

confidence: 98%

Strategies for the management of haemorrhage following pelvic fractures and associated trauma-induced coagulopathy

Mauffrey

Cuellar

Pieracci

et al. 2014

The Bone & Joint Journal

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Exsanguination is the second most common cause of death in patients who suffer severe trauma. The management of haemodynamically unstable high-energy pelvic injuries remains controversial, as there are no universally accepted guidelines to direct surgeons on the ideal use of pelvic packing or early angio-embolisation. Additionally, the optimal resuscitation strategy, which prevents or halts the progression of the trauma-induced coagulopathy, remains unknown. Although early and aggressive use of blood products in these patients appears to improve survival, over-enthusiastic resuscitative measures may not be the safest strategy. This paper provides an overview of the classification of pelvic injuries and the current evidence on best-practice management of high-energy pelvic fractures, including resuscitation, transfusion of blood components, monitoring of coagulopathy, and procedural interventions including pre-peritoneal pelvic packing, external fixation and angiographic embolisation.

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Comparing the predictive value of the pelvic ring injury classification systems by Tile and by Young and Burgess

Cited by 72 publications

References 25 publications

Pelvic ring injuries: Emergency assessment and management

Pelvic ring injuries: Emergency assessment and management

The importance of pelvic ring stabilization as a life-saving measure in pre-hospital – A case report commented by autopsy

Strategies for the management of haemorrhage following pelvic fractures and associated trauma-induced coagulopathy

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