Bailey James R, Stinner Daniel J, Blackbourne Lorne H, Hsu Joseph R, Mazurek Michael T
Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California 92134, USA.
J Trauma. 2011 Jul;71(1 Suppl):S58-61. doi: 10.1097/TA.0b013e31822154d8.
The purpose of this study was to describe pelvic fractures and their associated injuries in service members who either died of wounds or were killed in action during Operation Iraqi Freedom and Operation Enduring Freedom and define any differences in associated injuries between penetrating versus blunt injury to the pelvis.
A review of all service members who sustained a pelvis fracture during Operation Iraqi Freedom and Operation Enduring Freedom in the year 2008 was performed. Data were recorded for analysis.
One hundred four nonsurvivors were identified with pelvic fractures. Appropriate records, photos, and radiographs were available for 91, 70 were classified as "Not Survivable" (77%) and 21 "Potentially Survivable" (23%). Mechanisms of injury included 69 blast (76%), 14 gunshot wounds (15%), 4 motor vehicle accidents (4.5%), and 4 "other" (4.5%). Direct injury to the pelvis was penetrating in 60 (66%) and blunt in 31 (34%). Large pelvic vessel injury was observed more frequently in penetrating pelvic injuries (27%) than blunt injuries (3%). Hollow viscus abdominal injuries were more common in those with penetrating (57%) than blunt injuries (10%). There was an inverse relationship with intra-abdominal, solid organ injuries (blunt, 81%; penetrating, 55%). Head injuries were also more common in blunt pelvic injuries (blunt, 68%; penetrating, 45%), as were cardiopulmonary injuries (blunt, 84%, penetrating injuries, 57%).
Large pelvic vessel and hollow viscus injuries occur more frequently in penetrating combat-related pelvic fractures, whereas intra-abdominal solid organ, head, and cardiopulmonary injuries are more common in blunt pelvic injuries.
本研究的目的是描述在伊拉克自由行动和持久自由行动期间因伤死亡或在行动中阵亡的军人的骨盆骨折及其相关损伤，并确定骨盆穿透伤与钝性伤在相关损伤方面的差异。
对2008年伊拉克自由行动和持久自由行动期间发生骨盆骨折的所有军人进行了回顾。记录数据以供分析。
确定了104例骨盆骨折的非幸存者。91例有合适的记录、照片和X线片，其中70例被归类为“不可存活”（77%），21例为“可能存活”（23%）。损伤机制包括69例爆炸伤（76%）、14例枪伤（15%）、4例机动车事故伤（4.5%）和4例“其他”伤（4.5%）。骨盆直接损伤中，穿透伤60例（66%），钝性伤31例（34%）。骨盆穿透伤中大型盆腔血管损伤的发生率（27%）高于钝性伤（3%）。腹部中空脏器损伤在穿透伤患者中（57%）比钝性伤患者（10%）更常见。与腹腔内实性器官损伤呈负相关（钝性伤，81%；穿透伤，55%）。头部损伤在钝性骨盆损伤中也更常见（钝性伤，68%；穿透伤，45%），心肺损伤也是如此（钝性伤，84%，穿透伤，57%）。
在与战斗相关的骨盆骨折中，大型盆腔血管和腹部中空脏器损伤在穿透伤中更常见，而腹腔内实性器官、头部和心肺损伤在钝性骨盆损伤中更常见。
