Gumanenko E K, Shapovalov V M, Dulaev A K, Dydykin A V
Voen Med Zh. 2002 Oct;323(10):24-9, 96.
Basing on the analysis of medical record data obtained from servicemen with pelvic unstable injuries the authors evaluate the results and effectiveness of the used treatment methods and give the recommendations how to improve medical care rendered such category of casualties at the stages of medical evacuation. The analysis of treatment results obtained in the casualties with pelvic unstable injuries shoes high frequency (up to 24.4%) of unsatisfactory results among which not eliminate deformations of pelvic ring (14.3%), disordered walk (20.4%) and painful syndrome (18.8%) prevailed. In the structure of treatment measures during the local armed conflicts in Afghan and Chechnyathe conservative methods of hipbone immobilization (and even in the cases of pelvic unstable injuries) prevailed. Osteosynthesis with external apparatus was used only in 2.1% of the cases. Such treatment tactics resulted in the large number of unsatisfactory anatomical and functional outcomes of medical rehabilitation (46.8%), changes in servicemen fitness category (30.3%) their discharge and disability. To make the treatment of such category of casualties more effective it is necessary to conduct the appropriate surgical stabilization of pelvic fractures at the stage of specialized medical care with the use of modern methods of external and internal osteosynthesis.
基于对骨盆不稳定损伤军人病历数据的分析，作者评估了所采用治疗方法的结果和有效性，并给出了在医疗后送阶段如何改善对此类伤员医疗救治的建议。对骨盆不稳定损伤伤员治疗结果的分析显示，不满意结果的发生率较高（达24.4%），其中骨盆环畸形未消除（14.3%）、行走障碍（20.4%）和疼痛综合征（18.8%）最为常见。在阿富汗和车臣局部武装冲突期间的治疗措施结构中，髋骨固定的保守方法（甚至在骨盆不稳定损伤的情况下）占主导地位。仅2.1%的病例使用了外固定架骨固定术。这种治疗策略导致了大量医疗康复的解剖和功能结果不理想（46.8%）、军人健康类别改变（30.3%）、他们的退役和残疾。为了使此类伤员的治疗更有效，有必要在专科医疗阶段采用现代外固定和内固定骨固定方法对骨盆骨折进行适当的手术稳定。
