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Abstract
Purpose
The purpose of this study is to evaluate the relationship between the patterns of pelvic bone fracture and location of hemorrhage on angiography.
Materials and Methods
We retrospectively reviewed 56 patients with pelvic bone fracture and active bleeding. Fractures were classified according to Tile classification. Locations of bleedings were divided into four groups; main trunk/anterior/posterior divisions of internal iliac artery, and other locations. The relationship between the fracture pattern and bleedings were analyzed statistically.
Results
Forty-one bleedings were in 22 patients with type A fracture. Twenty (49%) were at the anterior division, 12 (29%) were at the posterior division, and 9 (22%) were found in other location. Thirty-three bleedings were in 23 patients with type B fracture. Fifteen (45%) were at the posterior division, 10 (30%) were at the anterior division, 3 (9%) were at the main trunk of the internal iliac artery, and 5 (16%) were at other location. Eighteen bleedings were in 11 patients with type C fracture. Thirteen (72%) were at the posterior division, 4 (22%) were at the anterior division, and 1 (6%) was at main trunk of internal iliac artery. Anterior divisional bleedings were more common in type A, posterior divisional bleedings were more common in type B and C fractures (p = 0.014).
Figures and Tables
Fig. 1
A 35-year-old male who has a compression injury on the lower abdomen.
A. Conventional pelvic AP view shows minimally displaced pubic bone fracture (arrows) suggestive of type A fracture.
B. Angiography shows contrast extravasation in the right obturator artery, a branch of the internal iliac artery anterior division (arrowhead).
Note.-AP = anteroposterior
Fig. 2
An 18-year-old male who had an motorcycle accident.
A, B. Conventional pelvic AP view and abdominopelvic CT shows fracture of the right pubic ramus and disrupted anterior margin of the left sacroiliac joint (arrows), suggestive of type B fracture.
C. Angiography shows active bleeding at the left main internal iliac artery (arrowhead).
Note.-AP = anteroposterior
Fig. 3
A 50-year-old female who was involved in a pedestrian-traffic accident.
A, B. Conventional pelvic AP view and abdominopelvic CT shows complete disruption of the right sacroiliac joint with vertical and rotational instability, suggestive of type C fracture (arrows).
C. Angiography shows active bleeding at the right superior gluteal artery, a branch of the internal iliac artery posterior division (arrowhead).
Note.-AP = anteroposterior
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