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[Classification and management of complex pelvic trauma].

U Bosch1, T Pohlemann, N Haas

  • 1Unfallchirurgische Klinik, Medizinische Hochschule Hannover.

Der Unfallchirurg
|April 1, 1992
PubMed
Summary

Complex pelvic trauma, involving fractures and soft tissue damage, has high mortality. A new grading system and trauma algorithm improve treatment by assessing fractures, soft tissue injuries, and patient stability.

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Area of Science:

  • Traumatology
  • Orthopedic Surgery
  • Emergency Medicine

Context:

  • Complex pelvic traumas involve both pelvic fractures and significant soft tissue injuries.
  • High mortality rates are associated with these injuries, primarily due to uncontrolled bleeding and sepsis.
  • Existing fracture grading systems inadequately address the severity of associated soft tissue damage.

Purpose:

  • To develop and introduce a novel grading system for complex pelvic traumas that incorporates soft tissue damage.
  • To present a trauma algorithm for improved primary management of patients with complex pelvic injuries.
  • To review the clinical course and outcomes of patients treated for complex pelvic traumas.

Summary:

  • A new point-based grading system considers pelvic fractures, soft tissue injuries (including pelvic organs, vessels, nerves), and concomitant injuries.

Related Experiment Videos

  • A trauma algorithm guides therapeutic steps based on clinical, ultrasonic, and radiological assessments, prioritizing pelvic ring stability and hemodynamic status.
  • Review of 132 patients (1972-1990) showed 34.8% mortality; 62.9% underwent laparotomy and 51.7% had open reduction and internal fixation for unstable pelvic rings.

    • Impact:

    • The developed grading system and trauma algorithm aim to enhance the primary treatment and outcomes for complex pelvic injuries.
    • Immediate laparotomy, hemorrhage control, and surgical fixation of unstable pelvic rings are critical for successful management.
    • This approach addresses the complex therapeutic challenges and reduces mortality associated with severe pelvic trauma.