ROUTINE PELVIC X-RAY IN MULTIPLE TRAUMA PATIENTS IS IT NECESSARY?

Abstract

Routine pelvic roentgenography has been utilized for all multiple trauma patients referring to our emergency department according to Advanced Trauma Life Support (ATLS) rules. In this retrospective study, we claimed to assess the worth of routine pelvic x-Ray films. The charts and x-Rays of patients with multiple trauma who referred to Emergency Department of Dokuz Eylül University Hospital, between August-December'93 are evaluated. Eighteen patients who were unconscious, not well orientated and drunk were excluded from the study and the rest of the sixty five patients are divided into 3 groups (as seen above) according to their history, with directed questions regarding pelvic pain, and clinical examination of the pelvis;

a) Positive complaint and positive pelvic examination findings (28 patients),
b) Positive complaint or positive pelvic examination findings (4 patients),
c) Negative complaint and negative pelvic examination findings (33 patients).

Among 65 patients whose pelvic x-Ray were evaluated, fourteen (%22) cases with fracture had been identified and all of these patients belonged to group A. No fracture was identified in the rest total fiftyone (%78) patients belonging to groups A, B and C. The statistical significance between the groups were mentioned to be very very significant (p<0.001).

As a result, we concluded that a pelvic x-Ray should be performed in a routine manner in multiple trauma patients only if the patient is

a) Unconscious, not cooperative, drunk and
b) For the patients who are conscious, orientated and cooperative, if they have complaints in the history and positive examination findings at the same time.

So that in this way it is possible to
a) Decrease the amount of radiation that the patient receives,
b) Hinder occupation of emergency and radiology departments for a longer period,
c)Decrease the treatment costs.