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Related Experiment Video

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Vessel-sparing Excision and Primary Anastomosis
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Published on: January 7, 2019

Early embolization without external fixation in pelvic trauma.

Shinsuke Tanizaki1, Shigenobu Maeda, Hiroyuki Hayashi

  • 1Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui 910-8526, Japan. sytanizak@yahoo.co.jp

The American Journal of Emergency Medicine
|February 1, 2011
PubMed
Summary
This summary is machine-generated.

Early pelvic embolization without external fixation is a viable initial treatment for hemodynamically unstable pelvic fracture patients. This approach, utilizing angiography and embolization, shows promise in managing severe pelvic injuries.

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Area of Science:

  • Trauma Surgery
  • Interventional Radiology
  • Emergency Medicine

Background:

  • Pelvic fractures can lead to significant hemorrhage and hemodynamic instability.
  • Traditional management often involves external fixation, which may delay definitive hemorrhage control.

Purpose of the Study:

  • To evaluate the efficacy of early pelvic embolization without external fixation in managing pelvic fractures.
  • To assess the safety and outcomes of this protocol in hemodynamically unstable patients.

Main Methods:

  • Retrospective review of 88 patients with pelvic fractures managed with a protocol of hemodynamic resuscitation and early pelvic embolization.
  • Patients with hemodynamic instability underwent angiography and embolization if CT showed pelvic extravasation.
  • External fixation of the pelvic ring was deliberately avoided.

Main Results:

  • 43 patients underwent angiography, with 29 (67%) showing positive findings for embolization.
  • The average time to angiography was 76.3 minutes.
  • The mortality rate among patients requiring angiography was 11%, with no embolization-related complications.

Conclusions:

  • Early pelvic embolization, when combined with hemodynamic resuscitation and without external fixation, is a potentially effective initial management strategy.
  • This protocol is particularly beneficial for patients with hemodynamic instability and evidence of pelvic extravasation on CT.
  • The approach demonstrated acceptable outcomes without significant complications.