TY  - JOUR
A1  - Gilbert, F.
A1  - Schneemann, C.
A1  - Scholz, C. J.
A1  - Kickuth, R.
A1  - Meffert, R. H.
A1  - Wildenauer, R.
A1  - Lorenz, U.
A1  - Kellersmann, R.
A1  - Busch, A.
T1  - Clinical implications of fracture-associated vascular damage in extremity and pelvic trauma
JF  - BMC Muscuskeletal Disorders
N2  - Background:
Vascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed.

Methods:
This comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group.

Results:
Vascular damage occurred in 7% of patients with upper and lower limb and pelvic fractures admitted to the trauma room. Overall survival was 80% in pelvic fracture and 97% in extremity fracture patients and comparable to non-vascular trauma patients. Additional arterial damage required substantial fluid administration and was visible as significantly anemia and disturbed coagulation tests upon admission. Open procedures were done in over 80% of peripheral extremity vascular damage. Endovascular procedures were predominant (87%) in pelvic injury.

Conclusion:
Vascular damage is associated with high mortality rates especially in combination with pelvic fractures. Initial anemia, disturbed coagulation tests and the need for extensive pre-clinical fluid substitution were observed in the cohort with vascular damage. Therefore, fast diagnosis and early interventional and surgical procedures are necessary to optimize patient-specific outcome.
KW  - endovascular repair
KW  - extremity trauma
KW  - fracture-associated vascular damage
KW  - level of evidence: IV
KW  - surgical trauma room
KW  - pelvic trauma
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-176252
VL  - 19
IS  - 404
ER  -