Patient selection: open pelvic fracture with rectal injuries
Predictors for pelvic infection and/or death:
(1) shock (infection)
(2) failure to perform a colostomy (infection)
(3) revised trauma score <= 8 (score range 0 to 12, incorporating respiratory rate, systolic blood pressure and Glasgow Coma Scale) (death)
Other risk factors from univariate analysis for infection:
(1) Gustilo-Anderson grade III soft tissue injury (extensive, flaps of soft tissue)
(2) massive blood transfusion (>= 10 units in the first 24 hours)
An unstable pelvic fracture should undergo:
(1) aggressive treatment of shock
(2) open reduction and internal fixation (ORIF)
(3) extensive debridement
(4) early colostomy if indicated
