Factors Associated with Pelvic Fractures in Polytrauma Patients with Orthopaedic Injuries

Objective: To calculate the proportion of pelvic fractures in patients admitted to the emergency department due to polytrauma and to reveal the associated risk factors.Methods: A total of 200 polytrauma patients with orthopaedic injuries were retrospectively evaluated.Demographic data such as age, gender, mechanism of injury, fracture locations, the Injury Severity Score (ISS), and the operation status of all patients were recorded.Fractures were categorized according to their anatomical locations: lower extremity fractures, upper extremity fractures, and pelvic fractures.Results: Among the patients, 79 (39.5%) had lower extremity fractures, 112 (56%) had upper extremity fractures, and 57 (28.5%) had pelvic fractures.Statistical analysis revealed significant correlations between the presence of pelvic fractures and female gender (P = 0.005), higher ISS scores (P = 0.005), the absence of requirement for surgery or fracture fixation (P < 0.001 for each), and the absence of upper and lower extremity fractures (P < 0.001 and P = 0.002, respectively).Detailed risk analysis was conducted after 2 x 2 cross tabulations were constructed, and it revealed that female gender, no requirement for surgery or fixation, and absence of upper or lower extremity fractures are associated with an increased likelihood of pelvic fractures among victims of polytrauma. Conclusion:The estimated proportion of pelvic fractures in patients with polytrauma and associated orthopaedic injuries is 28.5%.In this selected cohort of polytrauma patients with concomitant orthopaedic injuries, the absence of upper-and lower extremity fractures requiring surgical fixation was associated with pelvic fractures.However, this finding should be interpreted cautiously in light of potential patient selection bias and the influence of post-injury surgical decision-making.Further studies incorporating multivariable analyses are needed to clarify these associations.