Article Text

other Versions

PDF
Role of routine pelvic radiography in initial evaluation of stable, high-energy, blunt trauma patients
  1. Shahram Paydar1,
  2. Fariborz Ghaffarpasand2,
  3. Mehdi Foroughi3,
  4. Ali Saberi3,
  5. Maryam Dehghankhalili4,
  6. Hamidreza Abbasi1,
  7. Babak Malekpoor5,
  8. Ali Mohammad Bananzadeh6,
  9. Mohammad Vahid Hosseini6,
  10. Shahram Bolandparvaz1
  1. 1Trauma Research Center, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5Trauma Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6Trauma Research Center, Department of Pediatric Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
  1. Correspondence to Dr Fariborz Ghaffarpasand, Trauma Research Center, Shahid Rajaee Trauma Center—Chamran Avenue, Shiraz, Iran; Postal Code: 71345-1876 fariborz_ghaffarpasand{at}yahoo.com

Abstract

Background Pelvic fractures are among the most devastating traumatic injuries accompanied by high morbidity and mortality rate leading to catastrophic outcomes and haemodynamic consequences. Although Advanced Trauma Life Support (ATLS) recommends performing pelvic radiography in all major blunt trauma patients, several lines of evidence recommend that it can be limited to those blunt trauma patients who are haemodynamically unstable or have positive pelvic physical examination. Thus, we performed this study in order to evaluate the efficacy of routine pelvic radiography in haemodynamically stable, high-energy, blunt trauma patients.

Methods This was a prospective cross-sectional study including all the haemodynamically stable, high-energy, blunt trauma patients with negative pelvic physical examination referring to our trauma centre during a 5-month period (May–September 2010). Pelvic radiographies were performed and reviewed for abnormalities. In those who had negative pelvic physical examination and the radiography was not revealing enough, CT imaging was requested and reviewed.

Results During the study period, 1679 high-energy blunt trauma patients referred to our centre out of which 389 were haemodynamically stable and had negative pelvic physical examination. Pelvic radiography was found to be normal in all the patients except one (0.25%) who had pelvic fracture. Only three patients required CT imaging out of which two (0.5%) were found to be normal.

Conclusions Pelvic radiography could be eliminated from the primary survey protocol of the patients with high-energy blunt trauma who are haemodynamically stable and have negative pelvic physical examination.

  • Trauma, spine and pelvis

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.