Characteristics of pelvic injuries in a health region of New Zealand.

Background: Pelvic fractures involve a high volume of patients with low injury severity yet they are rarely described in the literature despite placing a considerable burden on hospital resources. This study aims to describe the demographics, mechanisms of injury, management and outcomes in patients who sustained pelvic trauma of all severities in a health region in New Zealand. Methods: A retrospective analysis of Te Manawa Taki Trauma Registry data between January 1, 2014 and December 31, 2023 was conducted. Included are patients admitted to hospital with injuries to the pelvic ring and/or acetabula classified with the Abbreviated Injury Scale. Results: A total of 3163 events were recorded and 53.5 % sustained severe pelvic injuries. The mean age was 45.9 years, 52 % male and 83.2 % non-Māori. The incidence throughout the study period averaged 33.7 per 100,000; however, in the final 3 years, the average incidence decreased to 25.9. Incidents most commonly occurred on streets/highways (46.5 %) and in the home (24.6 %). The mechanism of injury was blunt in 99.5 % of cases. Of the total, 76 % involved the pelvic ring, while 23.8 % were acetabular injuries. Additionally, 2.1 % of injuries were open. Posterior arch disruption was seen in 54 % of pelvic ring fractures, with 6.1 % showing complete disruption. The overall mortality rate for trauma admissions was 1.1 %, and 53.6 % of these patients had concurrent pelvic injuries. The case fatality rate of patients with pelvic injuries was 4.96 %. The mean length of stay was 12.1 days. Conclusion: Pelvic fractures of different severities are frequently associated with high energy mechanisms of injury and represent a significant burden on patients, their families/whānau and healthcare services. Clear preventative measures and care pathways are needed to reduce incidence and minimise morbidity and mortality.