Internal Fixation for Unstable Pelvic Ring Injuries in Polytrauma Patients

2009 ◽  
Vol 16 (3) ◽  
pp. 74-79
Author(s):  
V A Sokolov ◽  
E I Byalik ◽  
Aleksey Maksimovich Fayn ◽  
D V Evstigneev ◽  
V A Sokolov ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Functional Results ◽  
Symphysis Pubis ◽  
Multiple Injury ◽  
Scientific Research Institute ◽  
Pelvic Fractures ◽  
Basic Part ◽  
Pelvic Ring Injuries ◽  
Polytrauma Patients ◽  
Unstable Pelvic Ring Injuries

During the period from 1997 to 2008 three hundred twenty two polytrauma patients with unstable pelvic ring injuries were operated on at the department of concomitant and multiple injury of Sclifosovskiy Scientific-Research Institute for Emergency Care. External fixation of pelvic ring fragments was the basic part of antishock therapy. Avulsion of symphysis pubis was treated using original pelvic plate. In multiple pelvic fractures two specially designed reconstructive plates were applied via 2 endopelvic mini approaches. Elaborated treatment tactics enabled to achieve good anatomical and functional results in the majority of patients.

scholarly journals Accuracy of the WSES classification system for pelvic ring disruptions: an international validation study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Szu-Han Wang ◽  
Chih-Yuan Fu ◽  
Francesco Bajani ◽  
Marissa Bokhari ◽  
Justin Mis ◽  
...  
Keyword(s):  
Vascular Injury ◽  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Mortality Rates ◽  
Pelvic Fractures ◽  
Vascular Injuries ◽  
Infection Rates ◽  
Pelvic Ring Injuries ◽  
Closed Fractures ◽  
Unstable Pelvic Ring Injuries

Abstract Background In 2017, a novel classification for pelvic injuries was established by the World Society of Emergency Surgery (WSES). We validated its effectiveness using nationwide real-world data. The roles of associated vascular injury and open fracture in this system were also evaluated. Methods Patients with pelvic fractures in the National Trauma Data Bank 2015 dataset were retrospectively studied. First, the mortality rates were compared by WSES classification. Second, independent predictors of mortality were evaluated using a multivariate logistic regression model. Patients with and without associated vascular injuries and the same hemodynamic and pelvic ring stability statuses were compared. Patients with associated vascular injuries were compared to the proportion of nonsurvivors and survivors with unstable pelvic ring injuries. Third, the outcomes were compared between patients with open pelvic fracture and closed pelvic fracture in the mild, moderate and severe WSES classes. Results During the 12-month study period, 44,163 blunt pelvic fracture patients were included. The mortality rates were 1.8%, 3.8% and 10.6% for the mild, moderate and severe WSES classes, respectively (p < 0.001). MLR analysis showed that unstable pelvic ring injury did not significantly affect mortality (p = 0.549), whereas open pelvic fracture and associated vascular injury were independent predictors of mortality (odds of mortality: open pelvic fracture 1.630, p < 0.001; associated vascular injury 1.602, p < 0.001). Patients with associated vascular injuries showed that there was no significant difference in the proportion of patients with unstable pelvic ring injuries between survivors and nonsurvivors (37.2% vs. 32.7%, p = 0.323). In all three classes, patients with open pelvic fractures had significantly higher mortality rates and infection rates than patients with closed fractures (mortality rates: minor 3.5% vs. 1.8%, p = 0.009, moderate 11.2% vs. 3.3%, p < 0.001, severe 23.8% vs. 9.8%, p < 0.001; infection rates: minor 3.3% vs. 0.7%, p < 0.001, moderate 6.7% vs. 2.1%, p < 0.001, severe 7.9% vs. 2.8%, p < 0.001). Conclusions Based on this nationwide study, the WSES guideline provides an accurate and reproducible classification of pelvic fractures. It is recommended that open/closed fractures and associated vascular injuries be evaluated as supplements of the WSES classification.

scholarly journals Epidemiology and aetiology of male and female sexual dysfunctions related to pelvic ring injuries: a systematic review

2021 ◽  
Author(s):  
Giuseppe Rovere ◽  
Andrea Perna ◽  
Luigi Meccariello ◽  
Domenico De Mauro ◽  
Alessandro Smimmo ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Sexual Dysfunctions ◽  
Fracture Type ◽  
Ring Fracture ◽  
Male And Female ◽  
Pelvic Ring Injuries

Abstract Introduction Pelvic ring injuries, frequently caused by high energy trauma, are associated with high rates of morbidity and mortality (5–33%), often due to significant blood loss and disruption of the lumbosacral plexus, genitourinary system, and gastrointestinal system. The aim of the present study is to perform a systematic literature review on male and female sexual dysfunctions related to traumatic lesions of the pelvic ring. Methods Scopus, Cochrane Library MEDLINE via PubMed, and Embase were searched using the keywords: “Pelvic fracture,” “Pelvic Ring Fracture,” “Pelvic Ring Trauma,” “Pelvic Ring injury,” “Sexual dysfunction,” “Erectile dysfunction,” “dyspareunia,” and their MeSH terms in any possible combination. The following questions were formulated according to the PICO (population (P), intervention (I), comparison (C), and outcome (O)) scheme: Do patients suffering from pelvic fracture (P) report worse clinical outcomes (C), in terms of sexual function (O), when urological injury occurs (I)? Is the sexual function (O) influenced by the type of fracture (I)? Results After screening 268 articles by title and abstract, 77 were considered eligible for the full-text analysis. Finally 17 studies that met inclusion criteria were included in the review. Overall, 1364 patients (902 males and 462 females, M/F ratio: 1.9) suffering from pelvic fractures were collected. Discussion Pelvic fractures represent challenging entities, often concomitant with systemic injuries and subsequent morbidity. Anatomical consideration, etiology, correlation between sexual dysfunction and genitourinary lesions, or pelvic fracture type were investigated. Conclusion There are evidences in the literature that the gravity and frequency of SD are related with the pelvic ring fracture type. In fact, patients with APC, VS (according Young-Burgess), or C (according Tile) fracture pattern reported higher incidence and gravity of SD. Only a week association could be found between GUI and incidence and gravity of SD, and relationship between surgical treatment and SD. Electrophysiological tests should be routinely used in patient suffering from SD after pelvic ring injuries.

Initial experience with the T-Clamp for temporary fixation of mechanically and hemodynamically unstable pelvic ring injuries

Injury ◽  
2020 ◽  
Vol 51 (3) ◽  
pp. 699-704 ◽  
Author(s):  
Aresh Sepehri ◽  
Marcus F. Sciadini ◽  
Jason W. Nascone ◽  
Theodore T. Manson ◽  
Robert V. O'Toole ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Initial Experience ◽  
Pelvic Ring Injuries ◽  
Unstable Pelvic Ring Injuries

The past, present, and future management of hemodynamic instability in patients with unstable pelvic ring injuries

Injury ◽  
2020 ◽  
Author(s):  
Joshua A. Parry ◽  
Wade R. Smith ◽  
Ernest E. Moore ◽  
Clay C. Cothren Burlew ◽  
Cyril Mauffrey
Keyword(s):  
Pelvic Ring ◽  
Hemodynamic Instability ◽  
Pelvic Ring Injuries ◽  
The Past ◽  
Unstable Pelvic Ring Injuries ◽  
Future Management

The Longitudinal Short-, Medium-, and Long-Term Functional Recovery After Unstable Pelvic Ring Injuries

2019 ◽  
Vol 33 (12) ◽  
pp. 608-613 ◽  
Author(s):  
Michael E. Neufeld ◽  
Henry M. Broekhuyse ◽  
Peter J. OʼBrien ◽  
Pierre Guy ◽  
Kelly A. Lefaivre
Keyword(s):  
Functional Recovery ◽  
Pelvic Ring ◽  
Pelvic Ring Injuries ◽  
Unstable Pelvic Ring Injuries

scholarly journals Fixation of Pelvic-Acetabular Fractures Using a Midline-Modified Stoppa Approach: Clinical and Operative Outcomes

2018 ◽  
Vol 24 (1) ◽  
pp. 18-24
Author(s):  
Kenneth Kin-yan Chan ◽  
King-him Chui ◽  
Ka-chun Ip ◽  
Kin-bong Lee ◽  
Wilson Li
Keyword(s):  
Complication Rate ◽  
Injury Severity ◽  
Pelvic Ring ◽  
Functional Results ◽  
Bimodal Distribution ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Pelvic Ring Fractures ◽  
Stoppa Approach ◽  
Polytrauma Patients

Background/Purpose This served as the first report from our locality to evaluate the modified Stoppa approach, via a low-midline wound, for treating pelvic–acetabular fractures. Methods A total of 17 polytrauma patients with pelvic and/or acetabular fractures were consecutively treated using the modified Stoppa approach. They were followed up for at least 1 year postoperatively for radiographic and clinical assessments, which included the Modified Merle d'Aubigne Score, Harris Hip Score, and pain visual analogue scale. Results Among the 17 patients, 11 had pelvic ring fractures, two had isolated acetabular fractures, and four had a combination of both. Excellent and anatomical reduction was achieved in 73.3% of pelvic fractures and 71.4% of acetabular fractures. Functional outcomes simulated a bimodal distribution. Age of patient and Injury Severity Score were significant predictors for functional results, whereas fracture characteristics and quality of reduction were not correlated with clinical outcomes in this series. We experienced a low complication rate. Conclusion Excellent exposure for fracture reduction and fixation with low complication rate was achieved with the modified Stoppa approach. We were encouraged by the results of this preliminary series for treating pelvic–acetabular fractures in polytrauma patients.

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