scholarly journals Epidemiologic, Postmortem Computed Tomography-Morphologic and Biomechanical Analysis of the Effects of Non-Invasive External Pelvic Stabilizers in Genuine Unstable Pelvic Injuries

2021 ◽  
Vol 10 (19) ◽  
pp. 4348
Author(s):  
Christian Kleber ◽  
Mirja Haussmann ◽  
Michael Hetz ◽  
Michael Tsokos ◽  
Claas T. Buschmann
Keyword(s):  
Tensile Force ◽  
Volume Reduction ◽  
Biomechanical Analysis ◽  
Pelvic Injury ◽  
Postmortem Computed Tomography ◽  
Concomitant Injuries ◽  
Non Invasive ◽  
Pelvic Injuries ◽  
Pelvic Sling ◽  
Similar Peak

Unstable pelvic injuries are rare (3–8% of all fractures) but are associated with a mortality of up to 30%. An effective way to treat venous and cancellous sources of bleeding prehospital is to reduce intrapelvic volume with external noninvasive pelvic stabilizers. Scientifically reliable data regarding pelvic volume reduction and applicable pressure are lacking. Epidemiologic data were collected, and multiple post-mortem CT scans and biomechanical measurements were performed on real, unstable pelvic injuries. Unstable pelvic injury was shown to be the leading source of bleeding in only 19%. All external non-invasive pelvic stabilizers achieved intrapelvic volume reduction; the T-POD® succeeded best on average (333 ± 234 cm3), but with higher average peak traction (110N). The reduction results of the VBM® pneumatic pelvic sling consistently showed significantly better results at a pressure of 200 mmHg than at 100 mmHg at similar peak traction forces. All pelvic stabilizers exhibited the highest peak tensile force shortly after application. Unstable pelvic injuries must be considered as an indicator of serious concomitant injuries. Stabilization should be performed prehospital with specific pelvic stabilizers, such as the T-POD® or the VBM® pneumatic pelvic sling. We recommend adjusting the pressure recommendation of the VBM® pneumatic pelvic sling to 200 mmHg.

scholarly journals Diagnostic and treatment features of concomitant injuries of pelvis and abdomen in the emergency traumatology

2016 ◽  
Vol 97 (6) ◽  
pp. 837-841
Author(s):  
V F Chikaev ◽  
R I Zakirov ◽  
D G Zaydullin ◽  
R O Il’in ◽  
G M Fayzrakhmanova
Keyword(s):  
Minimally Invasive ◽  
Ct Scan ◽  
External Fixation ◽  
Damage Control ◽  
Pelvic Injury ◽  
Minimally Invasive Osteosynthesis ◽  
Concomitant Injuries ◽  
Pelvic Injuries ◽  
Fixation Devices ◽  
Full Body

Aim. Analysis of experience of treatment of patients with concomitant injuries of pelvis and abdomen in the emergency traumatology.Methods. Analysis of features of diagnosis and treatment of 77 patients with concomitant pelvic injuries admitted to Kazan City Clinical Hospital №7 was conducted.Results. The structure of concomitant pelvic injuries is characterized by a variety of injuries, often accompanied by severe shock. Concomitant pelvic injury in 74% of patients was accompanied by shock, and in 80% of cases it was II-III grade shock. To reduce the patient’s displacement in the admission ward full body CT scan was performed, and for clarifying the scope of injuries and tactics of management CT scan of injured organs was administered. During the first hour after admission to prevent dislocation of fractures and to stop intrapelvic bleeding external fixation devices in different modifications were used depending on the injury; that allowed stabilizing hemodynamics and condition of the victims. In the second step after stabilization of the patient’s state and hemodynamics and correction of homeostasis minimally invasive surgical interventions are recommended on day 5 to 7. If abdominal injury is identified, the optimal way of external fixation of fractures is C-type fixation frame, which allows adequate access for laparotomy.Conclusion. A patient with severe concomitant trauma needs urgent full body scan with subsequent X-ray CT, staging treatment based on the principal «Damage control», early fixation of pelvic fractures with the use of external fixation devices and subsequent minimally invasive osteosynthesis, and optimal external fixation device which allows adequate access in case of surgery.

scholarly journals Emergent Stabilization of Pelvic Bones Fractures in Polytrauma

2014 ◽  
pp. 19-25 ◽  
Author(s):  
E. A. Litvina
Keyword(s):  
General Condition ◽  
Pelvic Ring ◽  
Damage Control ◽  
Pelvic Injury ◽  
Treatment Concept ◽  
Concomitant Injuries ◽  
Surgical Interventions ◽  
Acute Period ◽  
Pelvic Injuries ◽  
Modern Treatment

Principle aspects of the management of patients with concomitant pelvic injury and injuries of other localization from the standpoint of modern treatment concept Damage control are discussed. Special attention are paid to the techniques for pelvic ring fixation, arrest of intrapelvic hemorrhage, sequence of surgical interventions depending on the pattern of concomitant injuries. The necessity of emergent pelvic injuries fixation with external devices as well as the fractures of other localization in the acute period until stabilization of patient’s general condition is substantiated

scholarly journals Emergent Stabilization of Pelvic Bones Fractures in Polytrauma

2014 ◽  
Vol 21 (1) ◽  
pp. 19-25
Author(s):  
E. A Litvina
Keyword(s):  
General Condition ◽  
Pelvic Ring ◽  
Damage Control ◽  
Pelvic Injury ◽  
Treatment Concept ◽  
Concomitant Injuries ◽  
Surgical Interventions ◽  
Acute Period ◽  
Pelvic Injuries ◽  
Modern Treatment

Principle aspects of the management of patients with concomitant pelvic injury and injuries of other localization from the standpoint of modern treatment concept Damage control are discussed. Special attention are paid to the techniques for pelvic ring fixation, arrest of intrapelvic hemorrhage, sequence of surgical interventions depending on the pattern of concomitant injuries. The necessity of emergent pelvic injuries fixation with external devices as well as the fractures of other localization in the acute period until stabilization of patient’s general condition is substantiated

Non-invasive ventilation (NIV) during endoscopic lung volume reduction

2007 ◽  
Vol 24 (Supplement 41) ◽  
pp. 37
Author(s):  
I. Rovira ◽  
M. Tió ◽  
M. Sadurní ◽  
M J. Jiménez ◽  
C. Agustí ◽  
...  
Keyword(s):  
Lung Volume ◽  
Volume Reduction ◽  
Invasive Ventilation ◽  
Lung Volume Reduction ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Surgical Treatment of Complicated Sacrum Fractures in Unstable Pelvic Injuries. Treatment Experience

2014 ◽  
Vol 21 (3) ◽  
pp. 72-76
Author(s):  
L. F Pak ◽  
V. E Volovik ◽  
O. N Li ◽  
I. A Goncharov ◽  
A. A An
Keyword(s):  
Intensive Care ◽  
Emergency Operation ◽  
Careful Examination ◽  
Nerve Injuries ◽  
Concomitant Injuries ◽  
Basic Principles ◽  
Functional Methods ◽  
Pelvic Injuries ◽  
Neurologic Disorders ◽  
Acute Condition

The majority of unstable pelvic injuries are accompanied by sacrum fractures of different localization. Experience in treatment of 8 patients with multiple concomitant injuries and sacrum fractures at the level of sacrum canal (Denis 3) is presented. All patients with acute condition were admitted into intensive care unit and underwent complex examination. At this step of intensive care the complexity of sacrum fractures and nerve injuries diagnosis is conditioned by the severity of patient’s condition. Patients with pelvic injuries require careful examination for detection of sacrum and nerve injuries in this region. However taking into account the multiplicity of injuries the emergency operation for nerve roots revision is not expedient. At rendering care to such patients the basic principles should be the conception of injuries control with preference given to stable and functional methods of fracture fixation. In our opinion all Denis 3 fractures with neurologic disorders require decompression-stabilizing operations that enable to mobilize patients, to determine and probably to improve the prognosis of neurologic pathology.

scholarly journals Characteristics of Patients with Pelvis injury in General Hospital of Haji Adam Malik Medan

2020 ◽  
Vol 13 (2) ◽  
pp. 103-109
Author(s):  
Irfan Ritonga ◽  
Chairiandi Siregar
Keyword(s):  
High School ◽  
General Hospital ◽  
Medical Record ◽  
Demographic Data ◽  
Secondary Data ◽  
Pelvic Injury ◽  
Common Mechanism ◽  
Tile Type ◽  
Distribution Diagram ◽  
Pelvic Injuries

Objective- Fractures and injuries to the pelvic ringmay be associated with severe trauma and other associated injuries. This study aims to determine the characteristics of patients with pelvic injury in Adam Malik Haji General Hospital Medan. Material and Method-The type of research conducted is a retrospective descriptive research method. This study was conducted in Medan Haji Adam Malik Hospital based on medical records of traumatic pelvic injury patients during the period of January 2016 - December 2017. The data used is secondary data taken from the records in the patient's medical record. The collected medical and demographic data is tabulated and presented in the form of a frequency distribution diagram or table and analyzed descriptively using total sampling. Results- During the period of research found from the medical record data of Medan Haji Adam Malik Hospital, there were 59 subjects with women as many as 18 subjects (30.5%) and 41 people (69.5%). . From the data collected, it was found that patients with a kindergarten background of 2 (16.9%), SD as many as 10 (16.9%) people, SMP as many as 8 (13.6%) people, high school as many as 25 (42, 4%) people, 10 (16.9%) people, and 4 (6.8%) people who don't go to school. Patients with tile type A1 total 12 patients (20.3%), tile type A2 as many as 18 people (30.5%), tile type B1 as many as 10 (16.9%), type tile B2 as many as 9 people (15.3 %), C1 tile type as many as 6 people (10.2%), C2 tile type as much as 1 (1.7%), and C3 tile type as much as 1 (1.7%). Patients with APC 1 compression type as many as 7 (11.9%) people, APC 2 as many as 13 (22%) people, APC 3 as many as 3 (5.1%) people, LC1 as many as 21 (35.6%) people, LC2 11 (18.6%) people, LC3 as many as 1 (1.7%) people, undefined as many as 2 (3.4%) people, and VS as many as 1 (1.7%) people. Conclusion- Patients who experience pelvic injuries are mostly male with an age range of 4-80 years. In terms of level of education, most patients are at the level of high school education. The most common mechanism of injury in pelvic injuries is lateral compression. The most common for tile classification is A2. Other most frequent injuries are lower limb fractures and the most common treatment for pelvic injuries are conservatives treatment.

Pilot study of temporary controllable gastric pseudobezoars for dynamic non-invasive gastric volume reduction

2009 ◽  
Vol 31 (2) ◽  
pp. 131-144 ◽  
Author(s):  
Martin P Mintchev ◽  
Marlena G Deneva ◽  
Bogdan I Aminkov ◽  
Michel Fattouche ◽  
Orly Yadid-Pecht ◽  
...  
Keyword(s):  
Pilot Study ◽  
Gastric Volume ◽  
Volume Reduction ◽  
Non Invasive

The Rocking Pelvis

2020 ◽  
pp. 67-74
Author(s):  
Hoi See Tsao ◽  
Robyn Wing
Keyword(s):  
Physical Examination ◽  
Diagnostic Tests ◽  
Treatment Options ◽  
Trauma Surgery ◽  
Pelvic Trauma ◽  
Pelvic Fractures ◽  
Concomitant Injuries ◽  
Pelvic Injuries ◽  
Retrograde Urethrogram ◽  
Rectal Injuries

This chapter reviews the pelvic and genitourinary physical examination in the setting of pelvic trauma, the types of pelvic fractures, and diagnostic tests available, including ultrasound, plain radiography, and computed tomography, to evaluate for pelvic injuries. It discusses the management principles of fluid resuscitation and hemorrhage control with an unstable pelvis, including consideration of consultation with trauma surgery, orthopedic surgery, and interventional radiology. It examines the types of concomitant injuries that may be expected, including splenic, hepatic, urethral, and rectal injuries and emphasizes the need for individualized workup and management for each patient based on a thorough physical examination. The indications for a retrograde urethrogram and treatment options for pelvic fractures are also briefly reviewed.

scholarly journals ASSOCIATED POSTERIOR PELVIC INJURY PATTERNS IN TRANSVERSE-ORIENTED ACETABULAR FRACTURE

2017 ◽  
Vol 25 (4) ◽  
pp. 151-154
Author(s):  
Ozgur Selek ◽  
Tuncay Baran ◽  
Umit Gok ◽  
Halil Ceylan ◽  
Ahmet Yilmaz Sarlak
Keyword(s):  
Acetabular Fracture ◽  
Pelvic Injury ◽  
Acetabular Fractures ◽  
Injury Patterns ◽  
Level Of Evidence ◽  
Results Of Treatment ◽  
Pelvic Injuries ◽  
Anatomic Reduction ◽  
Joint Separation

ABSTRACT Objective: Our study analyzed the incidence of posterior pelvic injury patterns and their influence on the surgical treatment of transverse-oriented acetabular fractures . Methods: Fifty-one transverse-oriented acetabular fracture cases admitted between 1999 and 2013 were evaluated retrospectively. Comparative studies were performed for groups organized by acetabular fracture type, degree of sacroiliac separation, and postoperative reduction quality . Results: Associated posterior pelvic injuries were found in 34 (66.7%) of the 51 patients. There were 32 sacroiliac separations in the 34 patients with associated posterior pelvic injury, and ipsilateral sacroiliac separations were more frequent in this subgroup. Measurements guided by computerized tomography showed that 16 sacroiliac separations were ≤0.5 cm (mean=0.43±0.14 cm), 10 were 0.5-1 cm (mean=0.73±0.17 cm), and the remaining 6 were >1 cm (mean=1.55±0.15 cm). In the group of 34 patients with associated posterior pelvic injury, acetabular reduction was anatomic in 19 (55.9%) patients, imperfect in 10 (29.4%) patients, and poor in 5 (14.7%) patients. For isolated acetabular fractures, reduction rates were as follows: 12 (70.6%) anatomic, 3 (17.6%) imperfect, and 2 (11.8%) poor. The rate of anatomic reduction was significantly higher when sacroiliac separation was ≤0.5 cm (p=0.027) . Conclusion: Associated posterior pelvic injuries, especially ipsilateral sacroiliac joint separation, accompany most transverse-oriented acetabular fractures and may influence the quality of acetabular reduction. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

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