Which pelvic XXXX are potentially lethal?

@entity1 @entity174 @entity548 @entity190 @entity5854 @entity130
PURPOSE: Global mortality of polytraumatised @entity1 presenting pelvic @entity174 remains high (330%), despite improvements in treatment algorithms in Level I @entity130 Centers. Many classifications have been developed in order to identify and analyse these pelvic ring lesions. However, it remains difficult to predict intra-pelvic @entity548 . The aim of this study was to identify pelvic ring anatomical lesions associated with significant @entity190 , susceptible to lead to life-threatening @entity548 . MATERIAL AND METHOD: This study focused on a retrospective analysis of @entity1 ' medical files, all of whom were admitted to one of the shock rooms of Grenoble University Hospital, France, between January 2004 and December 2008. Treatment was given according to the institutional algorithm of the Alps @entity130 Center and Emergency North Alpine Network @entity130 System (TRENAU). Different hemodynamical parameters at arrival were measured, and the @entity174 were classified according to Young and Burgess, Tile, Letournel and Denis. One hundred and ninety seven @entity1 were analysed. They were subdivided into two groups, embolised (Group E) and non-embolised (Group NE). RESULTS: Group NE included 171 @entity1 with a mean age of 40.2  8.7 years (15-90). Group E included 26 @entity1 with a mean age of 41.6  5.3 years (18-67). Twenty-six @entity1 died during the initial treatment phase. Eleven belonged to Group E and 15 to Group NE. Mortality was significantly higher in Group E (42.3% vs 8.8% in Group NE) (p<0.05). There were significantly many more Tile C unstable @entity174 in Group E (p=0.0014), and anterior lesions, according to Letournel, with pubic symphysis disruption were significantly more likely to lead to active @entity548 treated by selective embolisation (p=0.0014). Posterior pelvic ring lesions with iliac wing @entity174 and transforaminal sacral @entity174 ( @entity5854 ) were also more frequently associated with @entity548 treated by embolisation (p=0.0088 and p=0.0369 respectively). DISCUSSION/CONCLUSION: It appears that in our series the primary identification and classification of osteo-ligamentous lesions (according to Letournel and Denis' classifications) allows to anticipate the importance of @entity548 and to adapt the management of @entity1 accordingly, in order to quickly organise angiography with embolisation.
