Open pelvic fractures are devastating injuries, rare, and with high
mortality. Leading causes of mortality are: haemorrhage, infection and
associated injuries. The aim of this paper is to point out methods of
treating these injuries and great number of prognostic mortality factors.
Material - in period from January 2011 to December 2015, 221 patients with
pelvis ringfracture were treated in three large clinical centers of Serbia,
of which 13(5%) had an open fracture type. We have classified pelvic ring
fractures according to the Young - Burgess classification. We have
classified injuries according to Gustilo at I, II, and III degree, and the
location of the wound according to Faringer classification was distributed
in zone I, II and III. Urogenital and intra-abdominal injuries were
monitored, and severity of injuries was determined according to Severity
Score Injury (ISS) and Trauma Score (TS). Results - there were 6(46%) women
and 7(54%) men at the average age of 41(13 - 76). Injuries from traffic
trauma are dominant. The most common cause of pelvic ring fracture is an
anterior posterior compression - 6(46%), lateral compression - 4(31%) and
vertical force in 3 (23%) patients. Dominant injuries are type I and II
according to Gustilo, and zone I according to Faringer classification. There
were 6 (46%) patients with urogenital injuries, and the same number with
intra-abdominal injuries, of which 3(23%) patients have been treated with
colon resection and diversion. Due to abundant hemorrhage and hypovolemic
shock 2 patients died, and another one died after three days due to sepsis
and multisystem organ failure (MSOF). Conclusion - Open pelvic fractures
have high mortality rate, due to: haemorrhage, infection, associated
abdominal and genitourinary tract injuries, ISS> 25, TS <8 and age of
patient >65 years.
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