Holanda M, Culemann U, Burkhardt M, Pohlemann T
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Strasse 1, 66421 Homburg/Saar.
Chirurg. 2006 Sep;77(9):761-9. doi: 10.1007/s00104-006-1221-4.
Life-threatening complex pelvic fractures are commonly associated with vast peripelvine soft-tissue injuries and hemorrhage. Correct assessment and classification of the existing pelvic trauma and additional severe injuries present is required for accurate diagnosis and effective therapy. Treatment of the usually multiply injured patient is time-sensitive. The circulatory situation is the benchmark for diagnostic and therapeutic actions. Emergency stabilization of an initially unstable pelvic ring should be done first, followed by an extraperitoneal tamponade, if needed to control bleeding. The positive results of these actions can be measured by hemodynamic parameters. Delayed definitive internal stabilization of the anterior and/or posterior pelvic ring is then performed according to the fracture classification.
危及生命的复杂骨盆骨折通常伴有广泛的骨盆周围软组织损伤和出血。为了准确诊断和有效治疗，需要对现有的骨盆创伤和其他严重损伤进行正确评估和分类。对通常多处受伤的患者进行治疗具有时间敏感性。循环状况是诊断和治疗行动的基准。首先应对最初不稳定的骨盆环进行紧急稳定处理，如有必要控制出血，随后进行腹膜外填塞。这些措施的积极效果可以通过血流动力学参数来衡量。然后根据骨折分类对骨盆前环和/或后环进行延迟确定性内固定。
