Study of hemodynamic instability due to intrapelvic hemorrhage as a consequence of ilioischiopubian branch fractures in geriatric patients

• Published in: Revista espanola de cirugia ortopedica y traumatologia 2022, Vol.66 (3), p.223-226
• Main Authors: Molinero Montes, M, Fernández Álvarez, C, Fernández-Valdés Fernández, J M
• Format: Report
• Language: eng ; spa
• ISSN: 1988-8856
• DOI: 10.1016/j.recot.2021.02.005

INTRODUCTIONPelvic branch fractures are a common feature in old people which are usually treated conservatively. Massive hemorrhage is a strange complication that can compromise the patient's life. The objective of this study is to determine the incidence and possible risk factors of massive arterial injury in fractures of pelvic branches due to low energy trauma in patients over 65 years old. CLINICAL CASEObservational study of 142 patients diagnosed with pelvic branch fracture, We analyzed the age, sex, anatomical location, hemoglobin, need for hospital admission, complementary diagnostic test, complications and hospital stay. RESULTSAll those ilioisquiopubial fractures complicated with massive bleeding (4 patients) were located in the Nakatani area I in close relationship with the obturator artery, internal pudendal artery and the Corona Mortis. All patients needed supraselective embolization for hemorrhagic control. Three of the patients were taking anticoagulants. DISCUSSIONThe 2,8% of patients with pelvic branch fractures may suffer a hemorrhagic complication. Be able to establish possible risk factors such a medication or anatomical location can help us identify these patients and carry out closer surveillance.