Pelvic ring disruptions : effective classification system and treatment protocols

摘要: From January 1, 1985, to September 10, 1988, 210 consecutive patients with high-energy pelvic ring disruptions (exclusive of acetabular fractures) were admitted a statewide referral center for adult multiple trauma. They treated by one four attending orthopaedic traumatologists per protocol as determined their injury classification and hemodynamic status; the system was based on vector force involved quantification disruption from that force, i.e., lateral compression, anteroposterior vertical shear, combined mechanical injury. Of patients, 162 had complete charts: 126 (78.0%) directly scene, 110 (67.9%) injured in motor vehicle or motorcycle accidents, 25 (15.0%) shock (blood pressure less than 90 mm Hg), average Glasgow Coma Score 13.2, Injury Severity 25.8. Treatment fracture included following methods (alone combination): acute external fixation (45.0; 28.0%), open reduction/internal (22; 13.5%), arterial embolization (11; 7.0%), bedrest (68; 42.0%). Overall blood replacement averaged 5.9 units (lateral 3.6 units; 14.8 9.2 mechanical, 8.5 units). mortality 8.6% 7.0%; anteroposterior, 20.0%, 0%; 18.0%). The cause death associated 50%; no patient an isolated shear died. We conclude predictive value our (incorporating appreciation causative forces resulting patterns) classification-based treatment protocols reduce morbidity related disruption.