Orlando Regional Medical Center, Orlando, FL, USA.
J Am Acad Orthop Surg. 2013 Aug;21(8):448-57. doi: 10.5435/JAAOS-21-08-448.
Pelvic fractures range in severity from low-energy, generally benign lateral compression injuries to life-threatening, unstable fracture patterns. Initial management of severe pelvic fractures should follow Advanced Trauma Life Support protocols. Initial reduction of pelvic blood loss can be provided by binders, sheets, or some form of external fixation, which serve to reduce pelvic volume, stabilize clot formation, and reduce ongoing tissue damage. Persistently unstable patients may benefit from angiography with selective embolization, pelvic packing, or a combination of these interventions. Open pelvic fractures involving the perineum or bowel injury benefit from fecal diversion by colostomy. Trauma team coordination facilitates efficient resuscitative efforts and may affect definitive management by optimizing incision, ostomy, or catheter placement. Established protocols for both open and closed pelvic fractures help to standardize care.
骨盆骨折的严重程度范围从低能量、通常良性的侧方压缩损伤到危及生命的不稳定骨折模式。严重骨盆骨折的初始处理应遵循高级创伤生命支持方案。通过绑带、床单或某种形式的外固定来实现骨盆出血的初始减少，这有助于减少骨盆容积、稳定血栓形成并减少持续的组织损伤。持续不稳定的患者可能受益于选择性栓塞、骨盆填塞或这些干预措施的联合治疗的血管造影。涉及会阴或肠损伤的开放性骨盆骨折通过结肠造口术进行粪便转流。创伤团队协调有助于高效的复苏努力，并通过优化切口、造口或导管放置来影响确定性治疗。开放和闭合性骨盆骨折的既定方案有助于规范护理。
