51. Improved outcome with early fixation of skeletally unstable pelvic fractures
- Author
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A. Anthony Tarver, John S. Thalgott, Barbara A. Latenser, John W. Batdorf, and Larry M. Gentilello
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Adolescent ,Critical Care and Intensive Care Medicine ,Fixation (surgical) ,Fractures, Bone ,Injury Severity Score ,Blood loss ,Fracture Fixation ,Fracture fixation ,medicine ,Humans ,Child ,Pelvic Bones ,Aged ,business.industry ,Multiple Trauma ,Middle Aged ,medicine.disease ,Surgery ,Rehabilitation facility ,Outcome and Process Assessment, Health Care ,Orthopedic surgery ,Pelvic fracture ,business ,Hospital stay - Abstract
Thirty-seven consecutive patients with unstable pelvic fractures were divided into two groups: Group 1 (July 1981 to December 1984; n = 18), when early fixation was not routinely used, and Group 2 (January 1985 to March 1988; n = 19), when early fixation was performed unless contraindicated. Hospital stay decreased by 37.8% in Group 2 (p = 0.04). Of Group 1 patients, 60% were disabled for at least 6 months versus 15.7% in Group 2 (p = 0.001), and 45% were discharged to a rehabilitation facility versus 26.4% in Group 2. Group 1 had more complications, 1.3 per patient, versus 1.0. Patients in Group 2 (undergoing early fixation) required 27.2% fewer units of blood than those in Group 1 in whom fracture surgery was delayed. Survival was better in Group 2, 100% versus 83.3% (p = 0.06). Early pelvic fracture fixation reduces hospital stay, long-term disability, and may result in fewer complications, decreased blood loss, and better survival.
- Published
- 1991