ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Transferrals and clinical pathways of unstable pelvic fractures over the last 10 years - a retrospective analysis of the Trauma Register DGU
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePelvic fractures are classified as stable or unstable. They correlate with a severity of trauma and the initial medical treatment is decisive. This study evaluated the transferrals of such fractures and described the initial treatment as well as the clinical course.
methodsWe analysed retrospective data from a large cohort of the TraumaRegister DGU
resultsThe majority of the patients was male and about 53 years old. Blunt trauma was the leading trauma mechanism. Concomitant injuries (AIS 2+) affected thorax (56%), spinal cord (41%), lower extremities (38%), head (31%) and abdomen (24%). Among primary admitted cases with pelvic fractures (n = 36,398), 21,091 cases (57.9%) had an unstable pelvic fracture (AIS pelvis 3-5). Level 1 trauma centers not only treated 12,836 primary admitted cases with unstable pelvic fractures (83.5%) but also received 2,365 patients (15.4%) from other hospitals via transfer; while only 1% of cases were transferred out early (n = 170). Transfusion was administered in 5,984 patients (16.5%) (AIS 2-5). A pelvic binder was applied in 7,096 (36.3%) patients and surgical stabilisation was performed in 4,075 (14.9%) patients. The length of stay on intensive care unit was highest in AIS 5 with 6 days. The mortality rate was 38.5% in AIS 5, and 9.9% in AIS 2.
conclusionOver the course of the last 10 years, the prevalence of unstable pelvic ring fractures (AIS 3-5) constantly remained around 9%. Unstable pelvic fractures were increasingly transferred to a Level I trauma center. Unstable pelvic fractures correlated with a high Injury Severity Score (ISS). The early treatment involved the transfusion of packed red blood cells, the application of a pelvic binder and the surgical stabilisation. Though, these tools were increasingly utilized with the severity of trauma.
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