The Iowa orthopaedic journal
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A retrospective study of all patients (N = 343) with pelvic fractures admitted to our trauma service was conducted to evaluate the impact of pelvic fractures on mortality. All patients sustained additional injuries with an average Injury Severity Score (ISS) of twenty. Thirty-six patients died. ⋯ This greater than four-fold increase in deaths in the elderly appears to be an age related effect because the elderly patients generally had a lower ISS and less severe pelvic trauma than younger patients. We conclude that sustaining a pelvic fracture places the patient at an increased risk of death. Pelvic fractures contributed directly to death in one-third of the mortalities, one-third died from complications associated with pelvic fractures, and one-third died from other causes.
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We have treated four cases of previously quiescent osteomyelitis which presented as septic arthritis in an adjacent joint. The osteomyelitic focus was in the bone proximal to the involved joints (zero to ten centimeters above the joint line). ⋯ Aggressive surgical debridement of both bone and joint, followed by a prolonged course of antibiotics led to resolution in all patients. A high index of suspicion combined with adequate radiographs of the surrounding bones should lead to the appropriate diagnosis and treatment.