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Published in: European Journal of Trauma and Emergency Surgery 4/2015

01-08-2015 | Review Article

Haemorrhage in fragility fractures of the pelvis

Authors: S.-O. Dietz, A. Hofmann, P. M. Rommens

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2015

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Abstract

Introduction

Fragility fractures of the pelvis (FFP) are one of the most visible and debilitating consequences of osteoporosis. In contrast to pelvic ring fractures of the young, fragility fractures are caused by falls from a standing height or even by repetitive physiological loads. Even though haemorrhage is rarely found in fragility fractures of the pelvis, one must be aware of the potential risk.

Materials and methods

In a computer literature search, we identified eight papers about patients with haemorrhage and/or haemodynamic instability as a complication of a low-velocity pelvic ring fracture, all of which were case reports.

Conclusion

In our review, an overview of the case reports is provided, risk factors identified and a recommendation for the treatment and clinical observation given.
Literature
1.
go back to reference Hill RM, Robinson CM, Keating JF. Fractures of the pubic rami. Epidemiology and five-year survival. J Bone Joint Surg Br. 2001;83:1141–4.PubMedCrossRef Hill RM, Robinson CM, Keating JF. Fractures of the pubic rami. Epidemiology and five-year survival. J Bone Joint Surg Br. 2001;83:1141–4.PubMedCrossRef
2.
go back to reference Rommens PM, Hofmann A. Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury. 2013;44:1733–44.PubMedCrossRef Rommens PM, Hofmann A. Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury. 2013;44:1733–44.PubMedCrossRef
3.
go back to reference Papakostidis C, Giannoudis PV. Pelvic ring injuries with haemodynamic instability: efficacy of pelvic packing, a systematic review. Injury. 2009;40(Suppl 4):S53–61.PubMedCrossRef Papakostidis C, Giannoudis PV. Pelvic ring injuries with haemodynamic instability: efficacy of pelvic packing, a systematic review. Injury. 2009;40(Suppl 4):S53–61.PubMedCrossRef
4.
go back to reference Mears SC, Berry DJ. Outcomes of displaced and nondisplaced pelvic and sacral fractures in elderly adults. J Am Geriatr Soc. 2011;59:1309–12.PubMedCrossRef Mears SC, Berry DJ. Outcomes of displaced and nondisplaced pelvic and sacral fractures in elderly adults. J Am Geriatr Soc. 2011;59:1309–12.PubMedCrossRef
5.
go back to reference Chiu Y, Wong TC, Yeung SH. Haemodynamic instability secondary to minimally displaced pubic rami fractures: a report of two cases. J Orthop Surg (Hong Kong). 2009;17:100–2. Chiu Y, Wong TC, Yeung SH. Haemodynamic instability secondary to minimally displaced pubic rami fractures: a report of two cases. J Orthop Surg (Hong Kong). 2009;17:100–2.
6.
go back to reference Coupe NJ, Patel SN, McVerry S, Wynn-Jones CH. Fatal haemorrhage following a low-energy fracture of the pubic ramus. J Bone Joint Surg Br. 2005;87:1275–6.PubMedCrossRef Coupe NJ, Patel SN, McVerry S, Wynn-Jones CH. Fatal haemorrhage following a low-energy fracture of the pubic ramus. J Bone Joint Surg Br. 2005;87:1275–6.PubMedCrossRef
7.
go back to reference Garrido-Gómez J, Pena-Rodríguez C, Martín-Noguerol T, Hernández-Cortes P. Corona mortis artery avulsion due to a stable pubic ramus fracture. Orthopedics. 2012;35:e80–2.PubMed Garrido-Gómez J, Pena-Rodríguez C, Martín-Noguerol T, Hernández-Cortes P. Corona mortis artery avulsion due to a stable pubic ramus fracture. Orthopedics. 2012;35:e80–2.PubMed
8.
go back to reference Graham CP. Fatal haemorrhage following a low-energy fracture of the pubic ramus. J Bone Joint Surg Br. 2005;87:1700.PubMedCrossRef Graham CP. Fatal haemorrhage following a low-energy fracture of the pubic ramus. J Bone Joint Surg Br. 2005;87:1700.PubMedCrossRef
9.
go back to reference Hagiwara A, Fukushima H, Inoue T, Murata A, Shimazaki S. Brain death due to abdominal compartment syndrome caused by massive venous bleeding in a patient with a stable pelvic fracture: report of a case. Surg Today. 2004;34:82–5.PubMedCrossRef Hagiwara A, Fukushima H, Inoue T, Murata A, Shimazaki S. Brain death due to abdominal compartment syndrome caused by massive venous bleeding in a patient with a stable pelvic fracture: report of a case. Surg Today. 2004;34:82–5.PubMedCrossRef
10.
go back to reference Macdonald DJM, Tollan CJ, Robertson I, Rana B, Rana BS. Massive haemorrhage after a low-energy pubic ramus fracture in a 71-year-old woman. Postgrad Med J. 2006;82:e25.PubMedCentralPubMedCrossRef Macdonald DJM, Tollan CJ, Robertson I, Rana B, Rana BS. Massive haemorrhage after a low-energy pubic ramus fracture in a 71-year-old woman. Postgrad Med J. 2006;82:e25.PubMedCentralPubMedCrossRef
11.
go back to reference Martin S, Casey N. Haemorrhage requiring embolisation after low energy pelvic fracture in an elderly patient: a case report. Emerg Med J. 2010;27:722–3.PubMedCrossRef Martin S, Casey N. Haemorrhage requiring embolisation after low energy pelvic fracture in an elderly patient: a case report. Emerg Med J. 2010;27:722–3.PubMedCrossRef
12.
go back to reference Theodorides AA, Morgan BW, Simmons D. Haemodynamic instability resulting from a low energy pubic ramus fracture in a 78-year-old woman. A case report and review of the literature. Injury. 2011;42:722–4.PubMedCrossRef Theodorides AA, Morgan BW, Simmons D. Haemodynamic instability resulting from a low energy pubic ramus fracture in a 78-year-old woman. A case report and review of the literature. Injury. 2011;42:722–4.PubMedCrossRef
13.
go back to reference Taillandier J, Langue F, Alemanni M, Taillandier-Heriche E. Mortality and functional outcomes of pelvic insufficiency fractures in older patients. J Bone Spine. 2003;70:287–9.CrossRef Taillandier J, Langue F, Alemanni M, Taillandier-Heriche E. Mortality and functional outcomes of pelvic insufficiency fractures in older patients. J Bone Spine. 2003;70:287–9.CrossRef
14.
go back to reference Spencer J, Lalanadham T. The mortality of patients with minor fractures of the pelvis. Injury. 1985:6–8. Spencer J, Lalanadham T. The mortality of patients with minor fractures of the pelvis. Injury. 1985:6–8.
15.
go back to reference van Dijk WA, Poeze M, van Helden SH, Brink PRG, Verbruggen JP. Ten-year mortality among hospitalised patients with fractures of the pubic rami. Injury. 1985;16(5):321–3 (Elsevier Ltd).CrossRef van Dijk WA, Poeze M, van Helden SH, Brink PRG, Verbruggen JP. Ten-year mortality among hospitalised patients with fractures of the pubic rami. Injury. 1985;16(5):321–3 (Elsevier Ltd).CrossRef
16.
go back to reference Verbeek D, Sugrue M, Balogh Z, Cass D, Civil I, Harris I, et al. Acute management of hemodynamically unstable pelvic trauma patients: time for a change? Multicenter review of recent practice. World J Surg. 2008;32:1874–82.PubMedCrossRef Verbeek D, Sugrue M, Balogh Z, Cass D, Civil I, Harris I, et al. Acute management of hemodynamically unstable pelvic trauma patients: time for a change? Multicenter review of recent practice. World J Surg. 2008;32:1874–82.PubMedCrossRef
17.
go back to reference Hauschild O, Aghayev E, von Heyden J, Strohm PC, Culemann U, Pohlemann T, et al. Angioembolization for pelvic hemorrhage control: results from the German pelvic injury register. J Trauma Acute Care Surg. 2012;73:679–84.PubMedCrossRef Hauschild O, Aghayev E, von Heyden J, Strohm PC, Culemann U, Pohlemann T, et al. Angioembolization for pelvic hemorrhage control: results from the German pelvic injury register. J Trauma Acute Care Surg. 2012;73:679–84.PubMedCrossRef
18.
go back to reference Papakostidis C, Kanakaris N, Dimitriou R, Giannoudis PV. The role of arterial embolization in controlling pelvic fracture haemorrhage: a systematic review of the literature. Eur J Radiol. 2012;81:897–904.PubMedCrossRef Papakostidis C, Kanakaris N, Dimitriou R, Giannoudis PV. The role of arterial embolization in controlling pelvic fracture haemorrhage: a systematic review of the literature. Eur J Radiol. 2012;81:897–904.PubMedCrossRef
Metadata
Title
Haemorrhage in fragility fractures of the pelvis
Authors
S.-O. Dietz
A. Hofmann
P. M. Rommens
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2015
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0452-1

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