The Jones-Powell Classification of open pelvic fractures

Abstract

Epidemiologic study, level IV.

Profile, outcome and predictors of mortality of abdomino-pelvic trauma patients in a tertiary intensive care unit in Saudi Arabia

“…Overall mortality from pelvic fractures ranges from 5.0% to 16.0%, and patients aged greater than 65 with pelvic fractures have a mortality rate of approximately 20.0% [35]. Open pelvic fractures are associated with a mortality rate of up to 45.0% [36][37][38][39]. The majority of pelvis injuries are due to high-energy blunt trauma that increases the likelihood of concomitant injuries, likely involving the abdominal and pelvic viscera.…”

Trauma to the Pelvis: Injuries to the Rectum and Genitourinary Organs

“…Although less common with blunt bony pelvic injury, 25 % of patients with an open pelvic fracture have an associated rectal laceration (Jones-Powell class III). In this study, the highest mortality and highest ISS scores were for patients with a combination of open pelvic fracture and rectal laceration underscoring the synergistic effect of combined pelvic injuries on mortality [42]. Aside from the structures confined to the pelvis, the small bowel occupies the intraperitoneal portion of the pelvis and is also injured in 36 % of penetrating wounds to the rectum [41].…”

“…Careful initial inspection of the perineum for open wounds should be performed in the trauma bay to avoid missing the diagnosis. When associated with rectal laceration, mortality is especially high [33]. For open pelvic fractures, wound packing for hemorrhage control, early diverting colostomy, external fixation, and aggressive serial debridement should be performed [34].…”

The Road to Survival for Haemodynamically Unstable Patients With Open Pelvic Fractures

“…Bladder and urethral injuries are very common in patients with open pelvic fractures ( 6 ) however, associated injuries to the; thoracic spine, abdomen, head, and extremities are also likely ( 1 , 3 , 6 , 7 ). Age >65 ( 1 , 7 – 10 ), fracture instability ( 1 , 8 , 10 ), revised trauma score (RTS) <8 ( 7 , 8 , 11 , 12 ), hypotension and shock on arrival ( 7 , 9 , 12 ), large wounds and contamination ( 1 , 10 ), Glasgow Coma Scale (GCS) <8 ( 7 , 8 ), rectal injury ( 1 , 10 , 11 , 13 ), and the amount of blood transfused in the first 24 h ( 1 , 7 , 8 ) were identified in the literature as factors that contribute to mortality in these patients.…”