UAB Department of Orthopaedic Surgery Associate Professor and Director of the Orthopaedic Trauma Fellowship Clay Spitler, M.D., alongside Assistant Professor Joey Johnson, M.D., and current Orthopaedic Surgery residents have published a study reevaluating the treatment outcomes for complex open pelvic ring injuries.

The study was published in February of 2023 in the Injury: International Journal of the Care of the Injured and is titled “Management of open pelvic ring injuries”.

Open pelvic ring injuries are traumatic injuries that majorly disrupt the pelvic ring – such as fractures. Motorcycle collisions, motor vehicle collisions, and pedestrians struck by motor vehicles have been reported to be the most frequent cause of these injuries. Due to the rarity of open ring fractures, these injuries do not provide well-defined treatment plans for orthopaedic surgeons and their patients. Previous studies have shown mortality reaching 50% in open pelvic ring injuries, nearly five times higher than in closed pelvic ring injuries.

Spitler and the research team reviewed 58 scientific studies related to traumatic open pelvic ring injuries and their analyzed outcomes. Literature reviewed from the 1970s and 1980s reported mortality rates as high as 50%, while more recent studies from the 1990s reported mortality rates as low as 4.8%. This is due to the fulfillment of thorough protocols and advancements in the early treatment of open pelvic fractures including pelvic binders, diverting colostomies and emerging angiography.

The results show that individuals with short-term outcomes of open pelvic ring injuries have reported in-hospital mortality rates of 14–23.7%. Individuals with long-term outcomes have been limited to a small number of investigations. Complications seen with open pelvic fractures can be categorized into acute and delayed complications. Severe blood loss and shock are the most common causes of acute mortality while sepsis and multiple organ failure have been associated with delayed mortality.

In conclusion, the study suggests that the immediate recognition of associated injuries, blood loss control and respect for the location of the soft tissue aids in the successful management of short-term open pelvic fractures.

To read more about the study and its results, click here.