Conservative treatment in management of pelvic injuries

Abstract

Background. Pelvic ring injuries are complex, 3-8% of skeletal injuries, caused from severe traumas by high-energy collisions cam be associated with multisystem damage and high morbidity and mortality due to significant bleeding. Effective management is crucial for patient survival and recovery. Objectives of the study: To assess the current approaches for the treatment of pelvic ring injuries, contrasting the results of conservative and surgical methods. Material and methods: This study represents a retrospective analysis of clinical and radiological data for 24 patients with pelvic ring injuries treated in the department of traumatology nr.2, Institute of Emergency Medicine during the years 2022-2023. The cohort comprising 14 females (58%) and 10 males (42%). Patients were aged from 19 to 93 years, mean age was 54 years. Of these cases, 15 (63%) involved pubic bone fractures, 7 (29%) had multiple injuries of the pelvic ring, and 2 (8%) had iliac bone fractures. Isolated pelvic fractures were diagnosed in 19 cases, associated trauma was in 6 cases. All patients have been examined by a complex multidisciplinary team. Prompt provisional stabilization and immobilization of the pelvic ring were crucial during initial resuscitation. Results. In this study of 24 patients with pelvic ring injuries, pelvic binder application and hemodynamic stabilization were implemented if necessary. Conservative management was performed in 22 patients with stable fractures, enabling gradual recovery without surgery. Closed reduction with external fixation was done in 2 cases, enhancing functional outcomes. Conclusions. Pelvic ring injuries with early and appropriate stabilization should be done individually according to the fracture type and stability of the pelvic ring. Conservative therapy of stable pelvic injuries improves outcomes by promoting rapid mobilization and reducing complications. Keywords: Pelvic injury, stabilization, conservative treatment, closed reduction.