ABSTRACT
Background: Pelvic fractures are orthopaedic emergencies associated with polytrauma. These fractures have gradually increased in recent times as a result of increasing high speed and complex road traffic accidents. Objective: To describe the presentation and management outcome of patients that were managed in our institution for pelvic fractures over the study period. Methodology: We retrospectively reviewed the hospital records of patients who were admitted and treated in our hospital with pelvic injuries from February 2012 to January 2015. Results: Majority 122 (75.8%) of the patients in this study were aged below 40 years. These fractures were mostly caused by road traffic accidents. Most 116 (71.9%) of our patients had Tile class A and B fractures. Polytrauma seen in 41.6% of the patients was the most common associated injury seen with pelvic fractures. The mean Injury Severity Score (ISS) 31.4 shows that these patients were mostly severely injured patients. The fatality rate in this study was 16.12%. These mortality were higher for patients with Tile class C than B injury and no death was recorded for class A injuries. Conclusion: Majority of the patients were less than 40 years and Road Traffic Accident is the commonest aetiology. Many were successfully managed conservatively particularly those with stable and partially stable injuries. Functional outcome is generally good
Subject(s)
Injury Severity Score , Patients , PelvisABSTRACT
Background: Road traffic injury is of growing public health importance because of it significant contribution to the global disease burden. The need to predict outcome of injuries has led to the development of injury scores. The Kampala Trauma Score II (KTSII) now recommended for use in resource-poor settings; has not been compared with; the New Injury Severity Score (NISS) preferred by many authors. We compared the performance; predictive power; sensitivity; and specificity in predicting mortality at two weeks of the KTSII and NISS in patients involved in road traffic accidents seen on the surgical ward at Mbarara Regional Referral Hospital (MRRH). Methods: This prospective study conducted between June 2005 and August 2006; examined clinical and radiological data of 173 consecutive patients admitted to the emergency surgical ward at Mbarara Regional Referral Hospital with road traffic injuries. Only patients presenting within 24 hours of injury and with 3 or more injuries were recruited in the study. The KTS II and NISS scores were computed for each patient on admission. The primary outcome measure was survival. Receiver Operating Characteristics (ROC) analysis; and logistic regression analysis were used for comparison. Results: The KTSII predicted mortality and discharge with AUC of 0.87 (NISS; AUC 0.89). The KTSII was less accurate (AUC 0.65) than the NISS (AUC 0.83) in predicting long stay in the hospital. At cut off point of 9 and below; the KTSII had sensitivity of 87and specificity of 81while the NISS had 96and 78.4respectively in predicting mortality. e KTS IIpredicted long hospital stay at cut off score of 9 and below; with sensitivity of 87.5and specificity of 81.conclusions: The KTSII is as reliable a predictive score as is the NISS. This study demonstrated hat the KTS II provides reliable objective criterion upon which injured patients can be triaged in emergency care conditions. The KTS II may enhance the use of ambulance services and timely transfer of the injured and its use in trauma management should be further encouraged in resource-poor settings. In addition; the KTS II will make the documentation of the epidemiology of trauma more feasible in resource-poor settings