Gurevitz Shelly, Bender Benjamin, Tytiun Yehezkel, Velkes Steven, Salai Moshe, Stein Michael
Department of Orthopedic Surgery, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel.
Isr Med Assoc J. 2005 Oct;7(10):623-6.
Pelvic fracture poses a complex challenge to the trauma surgeon. It is associated with head, thoracic and abdominal injuries. As pelvic fracture severity increases so does the number of associated injuries and the mortality rate.
To report our experience in the treatment of pelvic fractures.
Between October 1998 and September 2001, 78 patients with pelvic fractures were admitted to our hospital. The age range of the 56 male and 22 female patients was 16-92 (mean 42 years). The cause of injury was road accident in 52 patients, fall from a height in 15, a simple fall in 9, and gunshot wounds in 2 patients. The Glascow Coma Scale score on arrival at the hospital was 3-15 (average 12). Twenty-five patients (32%) were admitted to the intensive care unit, 38 (48%) to the orthopedic department, 5 (6.4%) to neurosurgery and the remainder to a surgical department.
Twenty-six patients (33.3%) received blood transfusion in the first 24 hours. Of the 25 patients with associated head trauma, 6 had intracranial bleeding (32%); 29 patients (37%) had associated chest trauma, 28 (35.9%) had associated abdominal trauma, 16 (20.5%) had vertebral fractures and 40 (51.2%) had associated limb fractures. Pelvic angiography was performed in 5 patients (6.4%), and computed tomography-angiography of the cervical arteries and chest was performed in 1 and 5 patients respectively. Overall, a CT scan was performed in 56 patients (71.8%), of whom 25 (32%) had a pelvic CT on admission. Injury Severity Score was 4-66 (median 20). Laparotomy was performed in 14 patients (18%), spinal fusion in 5 (6.4%), limb surgery in 16 (20.5%), cranial surgery in 4 (5.02%), pelvic surgery in 10 (12.8%), chest surgery in 3 (3.85%), and facial surgery in 2 patients (2.56%). Seven patients (9%) died during the course of treatment.
Pelvic fracture carries a high morbidity rate. Associated chest, abdomen and limb injuries are often encountered. A multidisciplinary approach is needed to improve survival and outcome in patients with pelvic fractures.
骨盆骨折给创伤外科医生带来了复杂的挑战。它常伴有头部、胸部和腹部损伤。随着骨盆骨折严重程度的增加，相关损伤的数量和死亡率也会上升。
报告我们治疗骨盆骨折的经验。
1998年10月至2001年9月期间，我院收治了78例骨盆骨折患者。其中男性56例，女性22例，年龄在16 - 92岁之间（平均42岁）。受伤原因包括道路交通事故52例、高处坠落15例、单纯跌倒9例、枪伤2例。入院时格拉斯哥昏迷量表评分为3 - 15分（平均12分）。25例（32%）患者入住重症监护病房，38例（48%）入住骨科，5例（6.4%）入住神经外科，其余患者入住外科。
26例（33.3%）患者在最初24小时内接受了输血。在25例伴有头部外伤的患者中，6例有颅内出血（32%）；29例（37%）伴有胸部外伤，28例（35.9%）伴有腹部外伤，16例（20.5%）有脊椎骨折，40例（51.2%）伴有肢体骨折。5例（6.4%）患者进行了骨盆血管造影，1例和5例患者分别进行了颈动脉和胸部的计算机断层血管造影。总体而言，56例（71.8%）患者进行了CT扫描，其中25例（32%）入院时进行了骨盆CT扫描。损伤严重程度评分为4 - 66分（中位数20分）。14例（18%）患者进行了剖腹手术，5例（6.4%）进行了脊柱融合术，16例（20.5%）进行了肢体手术，4例（5.02%）进行了颅脑手术，10例（12.8%）进行了骨盆手术，3例（3.85%）进行了胸部手术，2例（2.56%）进行了面部手术。7例（9%）患者在治疗过程中死亡。
骨盆骨折发病率高。常伴有胸部、腹部和肢体损伤。需要多学科方法来提高骨盆骨折患者的生存率和治疗效果。
