Fracture Fixation ; methods ; trends ; Fractures, Bone ; surgery ; Humans ; Pelvic Bones ; injuries ; surgery

Fractures, Bone ; complications ; diagnosis ; surgery ; therapy ; Humans ; Pelvic Bones ; injuries ; surgery ; Time Factors

Fractures, Bone ; diagnosis ; diagnostic imaging ; surgery ; therapy ; Humans ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography

Pelvic fractures are serious injuries. Death within 24 hours is most often a result of acute blood loss. The emergency management of these patients is challenging and controversial. The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding. Management of hemodynamically unstable patients with pelvic fracture requires a multidisci- plinary team. The issues addressed in this management algorithm are diagnostic evaluation, damage control resuscitation, indications for noninvasive pelvic stabilization, preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography. This review article focuses on the recent body of know- ledge on those determinations.
Angiography ; Embolization, Therapeutic ; Fractures, Bone ; surgery ; Hemorrhage ; Humans ; Pelvic Bones ; injuries

The management of multiple complicated injured patients remains a great challenge despite advance- ments in modern medical care. We present a rare case of bilateral unstable pelvic fractures associated with bilateral segmental femoral shaft fractures.We have proposed a mechanism of such complex injury pattern and discussed the plan of management. We believe that a timely and aggressive surgical intervention to fix all the major fractures soon after medically stabilizing the patient helped our patient to overcome these serious and lethal injuries. It is necessary to establish an optimal protocol for management of such complex fractures by conducting prospective and multicentric studies in the future.
Adult ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; Humans ; Pelvic Bones ; diagnostic imaging ; injuries

Acetabulum ; injuries ; surgery ; Adult ; Female ; Fractures, Bone ; surgery ; Hip Injuries ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Spinal Fractures ; surgery ; Young Adult

OBJECTIVETo explore selection and efficacy assessment for membranous urethral trauma caused by pelvic fracture.

METHODSFrom June 2000 to August 2010, 72 patients with membranous urethral trauma caused by pelvic fracture were selected. There were 46 males and 26 females,ranging age from 26 to 62 years (averaged 35.2 years). The time from injury to hospitalization time was 1 to 3 hours. According to Tile pelvic fracture classification, there were 8 patients with type A, 45 patients with type B, 19 patients with type C. Thirty of the 35 patients with partial rupture of posterior urethral were treated by catheterization,5 patients treated by rupture anastomosis on the stage I combined with cystostomy; 25 of the 37 patients with complete rupture of posterior urethra were treated by early realignment, and 12 patients were treated by cystostomy. Urinary incontinence, impotence and urethrostenosis were evaluated.

RESULTSAll patients were followed up for 5 to 10 years (mean 7.7 years). Incidence of urethrostenosis, impotence and urinary incontinence in patients treated by cystostomy were significantly higher than rupture anastomosis on the stage I and early realignment (P < 0.05); while incidence in patients treated by catheterization was significantly lower than other groups (P < 0.05).

CONCLUSIONFor patients with partial rupture of posterior urethral, catheterization and rupture anastomosis on the stage I are preferred methods; while patients with complete rupture of posterior urethra, early realignment is a preferred method with advantages of simple operation and less complications.

Adult ; Female ; Fractures, Bone ; complications ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Retrospective Studies ; Urethra ; injuries ; surgery

An internal-external fixator for stabilization in three cases with unstable pelvic fractures were reported. Compared with external fixation, the internal-external fixator, which is placed in the subcutaneous layer, decreased the risk of pin-track infection, pin site pain, and bowel obstruction; meanwhile, it had the advantage of external fixation: it was easy to apply, controlled damage, and resulted in minimal injury.
Adolescent ; Adult ; Aged ; External Fixators ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Male ; Pelvic Bones ; injuries ; surgery

Angiography ; Balloon Occlusion ; Embolization, Therapeutic ; Fractures, Bone ; surgery ; Hemostasis, Surgical ; methods ; Humans ; Iliac Artery ; surgery ; Ligation ; Pelvic Bones ; injuries

OBJECTIVETo evaluate the modified Stoppa approach in treatment of pelvic and acetabular fractures.

METHODSFrom March 2010 to May 2012,16 patients with pelvic fractures and 7 patients with acetabutar fractures were treated by open reduction and internal fixation through the modified Stoppa approach,involving 18 males and 5 females with an average age of 39 years ranging from 17 to 65. By Tile classification, 16 cases of pelvic fractures included 1 case of B1, 2 of B2, 3 of B3, 4 of C1-1, 2 of C1-2, 2 of C1-3, and 1 of C2. By Letournel classification, 7 cases of acetabular fractures included 1 case of anterior column fractures, 1 of transverse fractures, 2 of type T, 1 of anterior column plus posterior transverse fractures, and 2 cases of both columns fractures. For 16 pelvic fractures, the modified Stoppa approach was used exclusively in 9 cases,in combination with the iliac fossa approach in 6 cases, and in combination with the posterior approach in 1 case. For 7 acetabular fractures, the modified Stoppa approach was used exclusively in 4 cases, in combination with the Kocher-Langenbeck approach in 2 cases, and in combination with the Kocher-Langenbeck and iliac fossa approaches in 1 case of both columns fractures.

RESULTSThe average operation time was 130 min (50 to 350 min) and the blood loss averaged 320 ml (100 to 1200 ml). There were no operative complications. The reductions of the pelvic and acetabular fractures were all excellent and good. Twenty-one patients were followed-up from 4 to 24 months (averaged 8 months). The fractures were all healed,the fracture healing time was 2.5 to 5 months (means 3.2 months). Among them, 1 case occurrenced screw loosening, 1 case had mild limited of hip flexion, no case had plate breakage and lateral ventral syndrome.

CONCLUSIONThe modified Stoppa approach can be used to treat pelvic and acetabular fractures effectively, and it has advantages of easy manipulation and a low complication rate.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Aged ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery