Abstract
Background Unstable pelvis injuries are one of the most difficult and severe trauma of musculoskeletal system that needs emergency measures. Aim of the study is the optimization of treatment tactics in unstable pelvis fractures in polytrauma patients. Маterial and methods This is a prospective study of treatment results of 96 polytrauma patients with unstable pelvic fractures type C. Unilateral injuries of the posterior pelvic ring were 85.42 % (n = 82), bilateral injuries were 14.58 % (n = 14) of cases. Diagnostic complex included physical examination, laboratory tests, X-rays and CT. Examination was carried out simultaneously with anti-shock measures and intensive care. Primary basic stabilization of the pelvis with an external device and fixation of the posterior ring were performed. Results and discussions Three patients died (3.13 %), the remaining 93 (96.87 %) patients completed treatment with good outcomes. The biomechanics of pelvic injuries shows us the necessity of external fixation. Unstable pelvis injuries in polytrauma patients with hemodynamic instability should be temporary stabilized to decrease the intrapelvic volume. Conclusions Primary stabilization of the pelvic ring is an effective therapeutic tactic that leads to a significant reduction in the severity of patients’ condition, prevention of post-traumatic complications and early functional recovery of the damaged organs.
Highlights
Complex injuries of the pelvic ring are accompanied by rotational and vertical instability [1–5], prolonged bleeding from the vessels of the pelvic bones, soft tissues and major venous plexuses
He was admitted with a concussion, “crushed chest,” ruptured diaphragm, intestine and bladder injuries, multiple fractures of the limbs and pelvis
Fixation of the pelvis stabilized the hemodynamics of patients at a safe level, what ensured a significant decrease in the volume of transfusion blood preparations and a decrease in the number of post-traumatic complications
Summary
Complex injuries of the pelvic ring are accompanied by rotational and vertical instability [1–5], prolonged bleeding from the vessels of the pelvic bones, soft tissues and major venous plexuses. The instability of the pelvic ring is associated with an increase in the internal volume of the pelvis. Internal fixation [11–17] is accompanied by prolonged surgical intervention, blood loss [6, 9, 18], and subsequently the shock-absorbing function of the pelvis decreases [14, 19, 20]. Aim of the study is the optimization of treatment tactics in unstable pelvis fractures in polytrauma patients. Маterial and methods This is a prospective study of treatment results of 96 polytrauma patients with unstable pelvic fractures type C. Primary basic stabilization of the pelvis with an external device and fixation of the posterior ring were performed
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