John T, Ertel W
Zentrum für spezielle Chirurgie des Bewegungsapparates, Klinik für Unfall- und Wiederherstellungschirurgie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
Orthopade. 2005 Sep;34(9):917-30. doi: 10.1007/s00132-005-0860-3.
Pelvic injuries represent a thorny and stubborn therapeutic challenge. Because major forces are required to fracture the pelvis, pelvic ring disruption, more than any other fracture, can lead to life-threatening associated injuries such as massive bleeding, organ injuries, and open fractures including hemipelvectomy. The rapid diagnosis and effective treatment ("damage control") of those injuries play the key role in the patient's survival, inasmuch as the mortality of multiply injured patients with pelvic ring disruption remains high with 20-35%. Exsanguinating hemorrhage represents the most dreaded acute complication of pelvic injuries. Therefore, diagnostic and therapeutic procedures have to be primarily adapted to the hemodynamics of the patient, secondarily to injuries of the brain and the torso. The time point and the techniques of definitive pelvic ring stabilization may be different in the patient with multiple injuries compared to isolated pelvic ring injuries.
骨盆损伤是一个棘手且顽固的治疗挑战。由于需要巨大外力才能造成骨盆骨折，骨盆环中断比其他任何骨折更易导致危及生命的相关损伤，如大量出血、器官损伤以及包括半侧骨盆切除术在内的开放性骨折。这些损伤的快速诊断和有效治疗（“损伤控制”）对患者的生存起着关键作用，因为骨盆环中断的多发伤患者死亡率仍然很高，为20% - 35%。失血性出血是骨盆损伤最可怕的急性并发症。因此，诊断和治疗程序必须首先适应患者的血流动力学，其次适应脑和躯干的损伤。与单纯骨盆环损伤的患者相比，多发伤患者骨盆环确定性固定的时间点和技术可能有所不同。
