Analysis of the effect of arterial embolization combined with external fixation in the treatment of unstable pelvic fracture with hemorrhagic shock

To assess the clinical efficacy and safety of comparing arterial embolization (AE) combined with external fixation (EF) versus EF alone in the treatment of unstable pelvic fractures with hemorrhagic shock. Ninety patients with unstable pelvic fracture with hemorrhagic shock admitted to our hospital from March 2017 to February 2025 were collected and divided into AE + EF group (n = 45) and EF group (n = 45) according to treatment. Initial vital signs, ISS score, shock index SI, initial systolic blood pressure SBP, postoperative 24 h red blood cell transfusion volume, hemostasis success rate, ICU stay time, and in-hospital mortality rate were recorded and compared between the two groups. Baseline characteristics (age, ISS score, shock index, preoperative and intraoperative blood transfusions, and initial systolic blood pressure) were not statistically different between the two groups (P > 0.05). Compared with the EF group, the AE + EF group had a low 24-h postoperative red blood cell transfusion (2.0 [0-3.0] vs. 3.0 [2.0-3.5] U, P = 0.028), a high success rate of hemostasis (97.78% vs. 82.22%, P = 0.030), and a short ICU stay ( 4.0 [2.0-8.0] vs. 7.0 [5.0-9.0] days, P = 0.020), and low mortality (4.44% vs. 24.44%, P = 0.016). Compared with EF alone, AE combined with EF significantly improves hemostasis, reduces transfusion dependence, decreases ICU burden, and results in decreased mortality in patients with unstable pelvic fractures with hemorrhagic shock. It is recommended as the preferred treatment option for patients with hemodynamically unstable pelvic fractures with hemorrhagic shock.