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Published on: October 15, 2021
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Diagnosis and Management of Traumatic Hemipelvectomy
David A Patch1, Matthew C Hess, Clay A Spitler
1From the Department of Orthopaedic Surgery, The University of Alabama at Birmingham, Birmingham, AL.
The Journal of the American Academy of Orthopaedic Surgeons
|September 27, 2022
Summary
Traumatic hemipelvectomy (THP) is a severe pelvic injury. Early amputation is a lifesaving intervention for hemorrhage control and improved survival in these critical trauma cases.
Area of Science:
- Trauma surgery
- Orthopedic surgery
- Emergency medicine
Background:
- Traumatic hemipelvectomy (THP) is a rare but devastating injury resulting from high-energy trauma.
- It involves complete dislocation of the hemipelvis with disruption of pelvic joints and iliac vessels, leading to high mortality.
- Mortality is primarily due to exsanguination, infection, and multiple system organ failure.
Purpose of the Study:
- To highlight the critical nature of traumatic hemipelvectomy (THP).
- To emphasize the importance of immediate recognition and intervention for survival.
- To discuss the role of emergent amputation in managing these severe pelvic injuries.
Main Methods:
- Review of literature and clinical case considerations for traumatic hemipelvectomy.
- Emphasis on initial assessment including physical examination for arterial damage.
- Focus on hemorrhage control and resuscitation strategies.
Main Results:
- Prompt recognition and intervention are crucial for patient survival.
- Vigorous resuscitation and hemorrhage control are paramount.
- Emergent amputation has been identified as a life-saving procedure in select cases.
Conclusions:
- Traumatic hemipelvectomy (THP) requires immediate multidisciplinary intervention.
- Early amputation can achieve hemostasis and reduce complications.
- Improved understanding and communication enhance patient outcomes in massive pelvic injuries.
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