Tscherne H, Pohlemann T, Gänsslen A
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Zentralbl Chir. 2000;125(9):717-24. doi: 10.1055/s-2000-10662.
For primary evaluation, classification and indication of pelvic ring injuries the exact knowledge of the injury mechanism and the clinical and radiological signs is mandatory. Clear injury definitions are proved for prognostical reasons and for the timing of the specific treatment. The simple classification of stable A-type injuries, rotational B-type injuries and translationally stable C-type injuries is the basis for further treatment. Whereas A-type fractures normally need no surgical stabilization, except in severely displaced fractures or possible organ injuries due to fracture fragments, in B-type injuries solely stabilization of the anterior pelvic ring provides sufficient stability for early ambulation with partial weight bearing. In C-type injuries a combined posterior and anterior stabilization is required for anatomical reduction and early ambulation. With this concept the pelvic girdle can be reconstructed anatomically in the majority of cases.
对于骨盆环损伤的初步评估、分类及指征而言,准确了解损伤机制以及临床和放射学征象是必不可少的。出于预后原因及特定治疗时机的考虑,明确的损伤定义已得到证实。稳定的A型损伤、旋转性B型损伤及平移稳定型C型损伤的简单分类是进一步治疗的基础。A型骨折通常无需手术固定,除非骨折严重移位或骨折碎片可能导致器官损伤;而在B型损伤中,仅对骨盆前环进行固定就能为早期部分负重行走提供足够的稳定性。在C型损伤中,则需要前后联合固定以实现解剖复位和早期行走。基于这一理念,在大多数情况下骨盆带可实现解剖重建。