Percutaneous screw fixation and external stabilization as definitive surgical intervention for a pelvic ring injury combined with an acetabular fracture in the acute phase of polytrauma in Korea: a case report.

Journal of Trauma and Injury Pub Date : 2023-09-01 Epub Date: 2023-07-13 DOI:10.20408/jti.2023.0002
Hohyoung Lee, Myung-Rae Cho, Suk-Kyoon Song, Euisun Yoon, Sungho Lee
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引用次数: 0

Abstract

Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

经皮螺钉固定和外固定作为骨盆环损伤合并髋臼骨折急性期的决定性手术干预:1例报告
不稳定骨盆环损伤可能危及生命,并与多发创伤患者的高死亡率和并发症发生率相关。骨盆环损伤患者最常见的死亡原因是大出血。在复苏的情况下,外固定可以作为不稳定骨盆骨折止血的临时稳定措施。盆腔环临时外固定后的内固定可获得更好、更可靠的稳定。然而,由于无法接受的生理状况和/或多发损伤,骨盆环切开复位内固定的延长入路常常被排除在外。保守治疗可能导致盆腔环畸形,这与各种功能障碍有关,如肢体长度差异、步态障碍和坐姿不耐受。因此,如果患者因预期生理状况不佳而不适合进行额外手术,则应考虑在急性期采用明确的外固定联合各种经皮螺钉固定来恢复骨盆环。在此,我们报告一例不稳定骨盆环损伤患者在急性期成功地采用明确的外固定和经皮螺钉固定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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