Pelvic fractures are serious injuries. Death within 24 hours is most often a result of acute blood loss. The emergency management of these patients is challenging and controversial. The key issues in its management ar...Pelvic fractures are serious injuries. Death within 24 hours is most often a result of acute blood loss. The emergency management of these patients is challenging and controversial. The key issues in its management are identifying the site（s） of hemorrhage and then controlling the bleeding. Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team. The issues addressed in this management algorithm are diagnostic evaluation, damage controlresuscitation, indications for noninvasive pelvic stabilization, preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography. This review article focuses on the recent body of knowledge on those determinations.展开更多
Objective： To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. Methods： This study was perform...Objective： To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. Methods： This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research, Chandigarh, with unstable pelvic injuries. Results： In the present study of 36 patients, 29 were managed surgically. Surgical duration was 2 hours in pa- tients operated on within 1 week and 3.4 hours in those operated on after 1 week. The blood loss was 550 ml when surgery was done after a week, but when done within a week it was 350 ml. The average blood loss through Pfanenstial approach was 360 ml, through posterior approach was 408 ml and through combined approach was 660 ml which was significantly high. Conclusion： Anterior approach to the pelvis would cause significantly more amount of blood loss than poste- rior approach and extemal fixation. Surgical approaches do not have any influence on the surgical duration or the infec- tion rate. The blood loss significantly increases when the surgical time is more than 1 h. The infection rate is not influ- enced by the duration of surgery. Presence or absence of associated injuries to the head, chest or abdomen is the main determinants of patient＇s survival and it greatly influ- ences the duration of hospital stay.展开更多
With rapid advancement in surgical techniques and improvement in implant materials, rate of internal fixation for pubic symphyseal disruption in rotationally and vertically unstable pelvic ring injuries has increased....With rapid advancement in surgical techniques and improvement in implant materials, rate of internal fixation for pubic symphyseal disruption in rotationally and vertically unstable pelvic ring injuries has increased. Among various modes of implant failure, screw/ plate breakage and loosening are common complications following unstable fixation. Migration of loose screws into the urinary bladder has been reported as an extremely uncommon complication of pubic symphyseal plating. Here we present a case report of a 52-year-old female who pre- sented with asymptomatic passage of screws in her urine following migration into the bladder, 2 years after symphy- seal plating for pubic diastasis in an anteroposterior compression pelvic ring injury.展开更多
文摘Pelvic fractures are serious injuries. Death within 24 hours is most often a result of acute blood loss. The emergency management of these patients is challenging and controversial. The key issues in its management are identifying the site（s） of hemorrhage and then controlling the bleeding. Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team. The issues addressed in this management algorithm are diagnostic evaluation, damage controlresuscitation, indications for noninvasive pelvic stabilization, preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography. This review article focuses on the recent body of knowledge on those determinations.
文摘Objective： To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. Methods： This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research, Chandigarh, with unstable pelvic injuries. Results： In the present study of 36 patients, 29 were managed surgically. Surgical duration was 2 hours in pa- tients operated on within 1 week and 3.4 hours in those operated on after 1 week. The blood loss was 550 ml when surgery was done after a week, but when done within a week it was 350 ml. The average blood loss through Pfanenstial approach was 360 ml, through posterior approach was 408 ml and through combined approach was 660 ml which was significantly high. Conclusion： Anterior approach to the pelvis would cause significantly more amount of blood loss than poste- rior approach and extemal fixation. Surgical approaches do not have any influence on the surgical duration or the infec- tion rate. The blood loss significantly increases when the surgical time is more than 1 h. The infection rate is not influ- enced by the duration of surgery. Presence or absence of associated injuries to the head, chest or abdomen is the main determinants of patient＇s survival and it greatly influ- ences the duration of hospital stay.
文摘With rapid advancement in surgical techniques and improvement in implant materials, rate of internal fixation for pubic symphyseal disruption in rotationally and vertically unstable pelvic ring injuries has increased. Among various modes of implant failure, screw/ plate breakage and loosening are common complications following unstable fixation. Migration of loose screws into the urinary bladder has been reported as an extremely uncommon complication of pubic symphyseal plating. Here we present a case report of a 52-year-old female who pre- sented with asymptomatic passage of screws in her urine following migration into the bladder, 2 years after symphy- seal plating for pubic diastasis in an anteroposterior compression pelvic ring injury.
