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[Traumatic hemipelvectomy].

J Heineck1, J Seifert, S Rammelt

  • 1Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinik Dresden, Fetscherstr. 74, 01307 Dresden. jan.heineck@uniklinikum-dresden.de

Der Unfallchirurg
|March 17, 2006
PubMed
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Traumatic hemipelvectomy, a rare pelvic injury, requires prompt field treatment and surgical intervention. Successful management can preserve function and high quality of life, even after limb-salvage attempts.

Area of Science:

  • Trauma Surgery
  • Orthopedic Surgery
  • Vascular Surgery

Background:

  • Traumatic hemipelvectomy is a rare and severe pelvic injury with a 0.6% incidence.
  • It involves hemipelvis avulsion, major vascular and nerve damage, and potential urogenital/anorectal complications.
  • Common mechanisms include extreme leg abduction/external rotation or machinery/crushing injuries.

Observation:

  • A patient with traumatic hemipelvectomy underwent immediate field treatment, followed by open revision, pelvic stabilization, and tamponade.
  • Initial attempts at upper leg preservation involved femoral vessel reconstruction using vascular prostheses.
  • Due to extensive soft tissue necrosis, a completion hemipelvectomy was necessary.

Findings:

  • The patient recovered well following the hemipelvectomy.

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  • Preservation of micturition, bowel evacuation, and sexual function was achieved.
  • High quality of life and successful social reintegration were reported.

    • Implications:

    • This case highlights the importance of rapid, multi-disciplinary management in traumatic hemipelvectomy.
    • Successful functional preservation and quality of life are achievable despite the severity of the injury.
    • Early surgical intervention and limb salvage attempts, followed by definitive management, are crucial for optimal outcomes.