{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:51:59Z","timestamp":1777924319720,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T00:00:00Z","timestamp":1469491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T00:00:00Z","timestamp":1469491200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study assesses the incidence of missed pelvic injuries in the pre\u2010hospital setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All blunt trauma patients (ISS \u2265 9) with pre\u2010hospital suspicion of and\/or radiologically proven pelvic fracture documented in the TraumaRegister DGU<jats:sup>\u00ae<\/jats:sup> (TR\u2010DGU) of the German Trauma Society DGU (2002\u20132011) were identified and retrospectively analyzed. Patients with a missed pelvic injury in the pre\u2010hospital period were compared with those who were correctly identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 11,062 patients included, 7201 patients (65.1 %) had a pelvic fracture diagnosed on hospital admission. In 44.1 % (<jats:italic>n<\/jats:italic> = 3178) of the patients with confirmed pelvic fracture, no pelvic injury was suspected pre\u2010clinically (overall sensitivity of the pre\u2010hospital pelvic examination: 55.9 %). For type B and C pelvic fractures, 40.5 % and 32.3 %, respectively, were not suspected in the pre\u2010hospital environment. Patients with a not\u2010suspected pelvic injury were significantly more likely to have been involved in a motor vehicle accident, to have a GCS \u2264 8, to be intubated at the scene and to have an ISS of \u226525 (all <jats:italic>p<\/jats:italic> &lt; 0.05). Independent risk factors for missing a pelvic injury in the pre\u2010hospital setting were an AIS head \u22653, a GCS \u2264 8 and age above 60 years. The presence of hypotension (SBP \u2264 90\u00a0mmHg) as well as a high overall injury severity (ISS \u2265 25) decreased the risk of missing a pelvic injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A significant proportion of severe pelvic fractures type B and C were not suspected in the pre\u2010hospital setting. Therefore, in severely injured blunt trauma patients, a mechanical pelvic stabilization in the pre\u2010hospital environment, irrespective of the findings of the physical examination of the pelvis, should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3647-2","type":"journal-article","created":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T17:46:50Z","timestamp":1469555210000},"page":"3073-3079","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The Reliability of the Pre\u2010hospital Physical Examination of the Pelvis: A Retrospective, Multicenter Study"],"prefix":"10.1002","volume":"40","author":[{"given":"Thomas","family":"Lustenberger","sequence":"first","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery University Hospital Frankfurt, Goethe\u2010University Frankfurt\/Main Theodor Stern Kai 7 60590 Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Walcher","sequence":"additional","affiliation":[{"name":"Department of Trauma University Hospital Leipziger Str. 44 Magdeburg A.\u00d6.R. 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