[Pelvic ring injuries: current concepts of management].
Pelvic ring injuries occur at any age. Most injuries to the pelvis are due to high-energy trauma, these injuries are therefore associated with abdominal, thoracic and head injuries. Unstable disruption of the pelvic ring has been often coupled with massive or life-threatening haemorrhage. The goal of the prehospital management is to keep airway open, start oxygen therapy, fluid replacement therapy and apply appropriate immobilization device. On admission of hemodynamically stable patients CT is preferred, for hemodynamically unstable the plain antero-posterior pelvis radiograph and ultrasound. To achieve hemodynamic stability, the pelvic C-clamp or external fixator should be applied. Pelvic packing or ligation of internal iliac artery is performed in the presence of arterial bleeding. In the acute period minimally invasive internal fixation with closed reduction should be used (transiliacal internal fixator, iliosacral screws). The open reduction with internal fixation can be performed after stabilization of the general state of health (after about 5 days), pelvic plates and spinopelvic fixation are appropriate for this approach. To recover the patient into normal life, bed rest and rehabilitation follows after surgical treatment.
Univerzita Karlova v Praze, Lékarská fakulta a FN Plzen, Klinika ortopedie a traumatologie pohybového ustrojí. martin.salasek@seznam.cz
Salásek
S
Martin
Pavelka
P
Tomás
D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D010384:Pelvic Bones / Q000293:injuries*