Emergency and Trauma of the Pelvic Ring

2017 ◽  
Vol 21 (03) ◽  
pp. 210-217 ◽  
Author(s):  
Victor Cassar-Pullicino ◽  
Miguel Pérez ◽  
Giuseppe Guglielmi ◽  
Antonio Leone
Keyword(s):  
Pelvic Ring ◽  
Three Dimensional ◽  
High Energy ◽  
High Rate ◽  
Pelvic Ring Injuries ◽  
Pelvic Ring Fractures ◽  
Appropriate Treatment ◽  
Initial Identification ◽  
Vascular Structures ◽  
Pelvic Viscera

Pelvic ring fractures are a common consequence of high-energy blunt trauma with a high rate of morbidity and mortality due to associated injuries, especially to the head, pelvic viscera, and vascular structures. The Young and Burgess classification system is the most widely utilized for categorizing pelvic ring injuries and assessing stability. The initial identification of these injuries often comes from an anteroposterior radiograph; however, computed tomography examination with three-dimensional volume-rendered reconstructions represents the reference standard and has essentially eliminated the requirement for inlet and outlet views. The appropriate treatment depends on a good knowledge of the anatomy and biomechanics of the pelvis. This review article underlines the importance of the integrity of ligaments to pelvic stability and describes the patterns of pelvic ring injuries and their associated mechanisms of injury.

Prehospital Stabilization of Pelvic Dislocations: A New Strap Belt to Provide Temporary Hemodynamic Stabilization

Swiss Surgery ◽  
1999 ◽  
Vol 5 (2) ◽  
pp. 43-46 ◽  
Author(s):  
Vermeulen ◽  
Peter ◽  
Hoffmeyer ◽  
Unger
Keyword(s):  
Pelvic Ring ◽  
High Energy ◽  
Early Mortality ◽  
High Rate ◽  
External Fixators ◽  
Early Complications ◽  
External Compression ◽  
Vascular Structures ◽  
The Cost ◽  
Accident Site

High energy pelvic fractures or dislocations are associated with a high rate of early complications, due to the associated intrapelvic organs. The high rate of early mortality is mostly due to the intrapelvic, retroperitoneal bleeding caused by the laceration of vascular structures located in the presacral area. External compression of the pelvic ring, using such devices as PASG or external fixators may prevent the intrapelvic collection of large hematomas by providing indirect tamponade. Unfortunately, these devices are either unavailable on the accident site, or the complexity of their handling is discouraging for the primary care-taker. A simple system of external pelvic compression which could be applied on the scene of trauma consisting of a pelvic strap-belt was therefore developed. The application of the device is easy, quick (30 seconds) and straightforward. Its use does not induce any known complications and requires minimal training. The cost and transportability of the system are further advantages. The system has already been used in 19 patients equipped on accident scene. Our first experiences using this device are reviewed.

Early fixation strategies for high energy pelvic ring injuries – the Zurich algorithm

Injury ◽  
2020 ◽  
Author(s):  
Simon Tiziani ◽  
Sascha Halvachizadeh ◽  
Adrian Knöpfel ◽  
Roman Pfeifer ◽  
Kai Sprengel ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
High Energy ◽  
Pelvic Ring Injuries ◽  
Early Fixation

scholarly journals High-Rate Layered Cathode of Lithium-Ion Batteries through Regulating Three-Dimensional Agglomerated Structure

Energies ◽  
2020 ◽  
Vol 13 (7) ◽  
pp. 1602 ◽  
Author(s):  
Jun-Ping Hu ◽  
Hang Sheng ◽  
Qi Deng ◽  
Qiang Ma ◽  
Jun Liu ◽  
...  
Keyword(s):  
Lithium Ion Batteries ◽  
Three Dimensional ◽  
Rate Capability ◽  
Lithium Ion ◽  
High Energy ◽  
High Rate ◽  
High Energy Density ◽  
High Rate Capability ◽  
Closed Structure ◽  
Short Lifecycle

LiNixCoyMnzO2 (LNCM)-layered materials are considered the most promising cathode for high-energy lithium ion batteries, but suffer from poor rate capability and short lifecycle. In addition, the LiNi1/3Co1/3Mn1/3O2 (NCM 111) is considered one of the most widely used LNCM cathodes because of its high energy density and good safety. Herein, a kind of NCM 111 with semi-closed structure was designed by controlling the amount of urea, which possesses high rate capability and long lifespan, exhibiting 140.9 mAh·g−1 at 0.85 A·g−1 and 114.3 mAh·g−1 at 1.70 A·g−1, respectively. The semi-closed structure is conducive to the infiltration of electrolytes and fast lithium ion-transfer inside the electrode material, thus improving the rate performance of the battery. Our work may provide an effective strategy for designing layered-cathode materials with high rate capability.

scholarly journals ‘Within Ring’ Concept Treatment for Displaced H-Shaped Type IVb Fragility Fractures of the Pelvis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yohei Yanagisawa ◽  
Yusuke Eda ◽  
Shotaro Teruya ◽  
Hisanori Gamada ◽  
Masashi Yamazaki
Keyword(s):  
Pelvic Ring ◽  
Pedicle Screws ◽  
Fragility Fractures ◽  
Clinical Results ◽  
High Energy ◽  
Fixation Method ◽  
Case Presentation ◽  
Pelvic Fixation ◽  
Pelvic Ring Fractures ◽  
Sacroiliac Rod Fixation

Introduction. Sacroiliac rod fixation (SIRF) preserves the mobility of L5/S1 (lumber in the pelvis), as a surgical procedure for high-energy pelvic ring fractures. The concept of SIRF method without pedicle screws into L4 and L5 is called ‘within ring’ concept. Case Presentation. We report here the clinical results of ‘within ring’ concept treatment with sacroiliac rod fixation for a case of displaced H-shaped Rommens and Hofmann classification type IVb fragility fractures of the pelvis (FFP), which A 79-year-old woman had been difficult to walk due to pain that had been prolonged for more than one month since her injury. The patient was successfully treated with SIRF, no pain waking with a walking stick and returned to most social activities including living independently within 6 months of the operation. Conclusion. SIRF is useful because it can preserve the mobility in the lumbar pelvis; not including the lumbar spine in the fixation range like spino pelvic fixation is a simple, safe, and low-invasive internal fixation method for displaced H-shaped type IVb fragility fractures of the pelvis.

High energy pelvic ring fractures, an overview over the past decade

2016 ◽  
Vol 102 (7) ◽  
pp. S97-S98
Author(s):  
Sara Machado ◽  
Luís Vieira ◽  
Rui Pinto ◽  
Isabel Pinto ◽  
Paulo Ribeiro De Oliveira ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
High Energy ◽  
The Past ◽  
Pelvic Ring Fractures

Three-dimensional networked Na3V2(PO4)3/C composite as high-performance cathode for aqueous zinc-ion battery

2021 ◽  
Vol 14 (02) ◽  
pp. 2150011
Author(s):  
Xiaoyong Fan ◽  
Ruibo Sun ◽  
Jiaxing Han ◽  
Yan Wu ◽  
Lei Gou ◽  
...  
Keyword(s):  
Electrochemical Performance ◽  
High Performance ◽  
Three Dimensional ◽  
High Capacity ◽  
High Energy ◽  
Zinc Ion ◽  
High Rate ◽  
High Energy Density ◽  
Soft Template ◽  
Ammonium Bromide

Na3V2(PO[Formula: see text] (NVP) as one typical Na[Formula: see text] super ionic conductor (NASICON) is recognized as an ideal cathode material for ZIBs owing to its promising structural stability that facilitates long cycle, rich vacancies and channels facilitate storing metal ions, high operating potentials to ensure high energy density. However, it still faces poor cyclability and high-rate capacity. Here, three-dimensional networked Na3V2(PO[Formula: see text]/C composite is synthesized by a microemulsion strategy with cetyltrimethyl ammonium bromide (CTAB) as the soft template, and the effect of aging temperature of microemulsion on their morphology and electrochemical performance is investigated. The Na3V2(PO[Formula: see text]/C composite derived from the precursor reacted at 70[Formula: see text]C shows micrometer-size particles assembled by three-dimensional networked nanoplates, facilitating for ions transport and delivers the best electrochemical performance. It displays a high first capacity of 102.2 mAh g[Formula: see text] with 42.3 mAh g[Formula: see text] remained after 5000 stable cycles (capacity retention of 41.4%) at 5 C, a high capacity of 83.2 mAh g[Formula: see text] even the current density is as high as 20 C, which is better than most of the reports.

scholarly journals Pelvic ring fractures in the elderly

2019 ◽  
Vol 4 (6) ◽  
pp. 313-320
Author(s):  
Markus A. Küper ◽  
Alexander Trulson ◽  
Fabian M. Stuby ◽  
Ulrich Stöckle
Keyword(s):  
Pelvic Ring ◽  
Weight Bearing ◽  
The Elderly ◽  
Thromboembolic Events ◽  
Pulmonary Infections ◽  
Partial Weight Bearing ◽  
Pelvic Ring Injuries ◽  
Pelvic Ring Fractures ◽  
Partial Weight ◽  
Posterior Ring

Pelvic ring fractures are rare injuries in the elderly though the incidence is increasing due to the increasing age of the population. Main goal of treatment is the quickest possible re-mobilization to prevent side-effects of immobilization such as osteopenia, pulmonary infections or thromboembolic events. Isolated anterior pelvic ring fractures are stable injuries and therefore they usually can be treated conservatively, while pelvic ring injuries with involvement of the posterior ring are considered unstable and should undergo surgical stabilization if the patient’s condition allows for it. Conservative treatment includes adequate analgesia, guided mobilization with partial weight bearing if possible and osteoanabolic medication. The appropriate surgical procedure should be discussed in an interdisciplinary round considering patient’s pre-injury condition, anaesthetic and surgical risks. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180062

scholarly journals Incidence rate and topography of intra-pelvic arterial lesions associated with high-energy blunt pelvic ring injuries: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna-Eliane Abboud ◽  
Sana Boudabbous ◽  
Elisabeth Andereggen ◽  
Michaël de Foy ◽  
Alexandre Ansorge ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pelvic Ring ◽  
High Energy ◽  
Arterial Lesion ◽  
Pelvic Ring Injuries ◽  
Computed Tomography Images ◽  
Arterial Lesions

Abstract Background The aim of this study was to determine the rate and topography of intra-pelvic arterial lesions associated with high-energy blunt pelvic ring injuries (PRI). Methods This retrospective cohort study was conducted in a level I trauma center serving 500,000 inhabitants. A total of 127 consecutive patients with high-energy blunt PRI were included between January 1st, 2014 and December 31st, 2017. Every patient had a total body or thoraco-abdominal computed tomography scan including contrast enhanced arterial sequences. A board-certified radiologist reviewed all the vascular images and precisely described every intra-pelvic arterial lesion in terms of localization. Complete pelvic series (standard radiographs and fine cut computed tomography images) were reviewed by three board-certified orthopedic surgeons experienced in PRI management, and Young and Burgess and AO/OTA classifications were determined. Demographic, clinical, therapeutic and outcome data were extracted from the institutional severely injured patients’ registry. Results Patients’ mean age was 45.3 years and 58.3% were males. Fifteen (11.8%) had a total of 21 intra-pelvic arterial lesions: seven lesions of the obturator artery, four of the superior gluteal artery, three of the inferior gluteal artery, two of the vesical artery, and one of each of the following arteries: internal iliac, internal pudendal, fifth lumbar, lateral sacral, ilio-lumbar. These lesions occurred in 8.6% of lateral compression injuries, 33.3% of anteroposterior compression injuries and 23.5% of vertical shear and combined mechanism injuries (Young and Burgess classification, p = 0.003); and in 0% of type A injuries, 9.9% of type B injuries and 35% of type C injuries (AO/OTA classification, p = 0.001). Patients with an intra-pelvic arterial lesion were more likely to present with pre-hospital hemodynamic instability (p = 0.046) and to need packed red blood cells transfusion within the first 24 h (p = 0.023; they needed a mean of 7.53 units vs. 1.88, p = 0.0016); however, they did not have a worst outcome in terms of complications or mortality. Conclusions This systematic study found an 11.8% rate of intra-pelvic arterial lesion related to high-energy blunt PRI. The obturator, superior gluteal and inferior gluteal arteries were most often injured. These findings are important for the aggressive management of high-energy blunt PRI.

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