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Updated: May 9, 2026

Right Hemihepatectomy by Suprahilar Intrahepatic Transection of the Right Hemipedicle using a Vascular Stapler

Right Hemihepatectomy by Suprahilar Intrahepatic Transection of the Right Hemipedicle using a Vascular Stapler

Published on: January 25, 2010

Traumatic hemipelvectomy: an appeal for primary completion.

Jan Lindahl^1,2, Minna Laitinen^3,4, Axel Gänsslen⁵

¹Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland. jan.lindahl@hus.fi.

Archives of Orthopaedic and Trauma Surgery

|May 2, 2025

Summary

This summary is machine-generated.

Traumatic hemipelvectomy (TH) is a severe pelvic injury requiring immediate, aggressive damage-control resuscitation. Primary completion of TH is recommended over limb salvage in critical ischemia or sacral plexus injury cases.

Keywords:

Case report Debridement Management Traumatic hemipelvectomy

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Area of Science:

Trauma Surgery
Orthopedic Surgery
Emergency Medicine

Background:

Traumatic hemipelvectomy (TH) represents a rare, life-threatening pelvic injury with high mortality.
Management challenges include severe pelvic fractures, associated injuries, and potential exsanguination.
Existing literature primarily focuses on survivors, lacking comprehensive treatment guidelines.

Purpose of the Study:

To outline aggressive, standardized damage-control strategies for managing traumatic hemipelvectomy.
To provide recommendations for surgical management, including limb salvage versus completion of hemipelvectomy.
To address critical aspects of resuscitation, vascular repair, and soft-tissue management.

Main Methods:

Review of current literature and case series on traumatic hemipelvectomy.
Emphasis on standardized damage-control procedures in prehospital, emergency room, and initial surgical phases.
Discussion of massive transfusion protocols, vascular injury management, and colostomy considerations.

Main Results:

Aggressive initial treatment is crucial to prevent exsanguination and contamination.
Massive transfusion protocols are vital for managing traumatic coagulopathy.
Primary completion of hemipelvectomy is often favored over limb salvage due to lower complication rates and better functional outcomes in specific cases (critical ischemia, sacral plexus injury).

Conclusions:

Standardized damage-control resuscitation is paramount for patients with traumatic hemipelvectomy.
Early surgical intervention should focus on preventing exsanguination and contamination.
Completion of hemipelvectomy is recommended in cases of critical ischemia and significant sacral plexus injury to improve outcomes.