title: Management of traumatic hemipelvectomy: an institutional experience on four consecutive cases.
abstract: OBJECTIVE
  The incidence of traumatic hemipelvectomy is rare, but it is a devastating injury. Recently, an increasing number of patients with traumatic hemipelvectomy are admitted to trauma centers alive due to improvements of the pre-hospital care. Successful management requires prompt recognition of the nature of this injury and meticulous surgical technique. We present our successful experiences on four cases of traumatic hemipelvectomy in the past nine years.
  
  
  METHODS
  Four cases with traumatic hemipelvectomy were admited to our hospital from June 21, 2002 to September 3, 2011. All injuries occurred due to vehicle accident and all patients were in a state of severe hypotension, with two of them having anal lacerations. These four cases were treated immediately with resuscitation, control of hemorrhage, early amputation, repeated debridement and closure of the wounds. An angiographic embolization was given to control hemorrhage in two of the cases preoperatively. One case underwent fecal diversion. Wound infection occurred in all of cases which was successfully controlled by repeated debridements, effective anti-biotic regimen, split-thickness skin grafts.
  
  
  RESULTS
  All four cases were saved successfully with well-healed wounds during follow up from 1 to 7 years. They were able to walk by themself using crutches.
  
  
  CONCLUSIONS
  Adhering to the surgery principles of damage control including appropriate resuscitation, hemorrhage control, coagulopathy correction and multiple debridements and closure of the wounds in reasonable period of time can save the life of cases suffering from severe pelvic ring injury.
authors: Tian-hao
authors: TH
authors: Wu
authors: Xi-rui
authors: XR
authors: Wu
authors: Xiao
authors: X
authors: Zhang
authors: Chun-sheng
authors: CS
authors: Wu
authors: Ying-ze
authors: YZ
authors: Zhang
authors: A-qin
authors: AQ
authors: Peng
mesh_terms: D000328:Adult; D002648:Child; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007869:Leg Injuries / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery*; D010388:Pelvis / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D015599:Trauma Severity Indices
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