Madani Tarik, El Alouani El Mehdi, Mhammdi Younes, Kharmaz Mohammed, El Ouadghiri Mohamed, Lahlou Abdou, Omar Lamrani Moulay, El Bardouni Ahmed, Mahfoud Mustapha, Berrada Mohamed Saleh
Service de Chirurgie Orthopédique et Traumatologique du Centre Hospitalier Universitaire de Rabat, Maroc.
Pan Afr Med J. 2017 Jun 15;27:122. doi: 10.11604/pamj.2017.27.122.8699. eCollection 2017.
The knowledge of the pathophysiology of patients with severe trauma and the hemodynamic and inflammatory consequences of initial surgical management has led many surgeons to change their approach to the treatment of patients with severe polytraumas associated with lesions of the pelvis or of limbs by integrating the principles of sequential treatment or Trauma Damage Control Orthopaedic (TDCO). We report the case of a patient involved in a public road accident, admitted to hospital in a state of shock with pelvic disjunction and hip dislocation complicated by vascular injury in the same limb. Our approach was based on TDCO concepts by favoring external fixation of the pelvis after hip dislocation reduction. The timeliness of our apprach allowed early limb revascularization while avoiding the hemodynamic and inflammatory complications of open surgery.
对严重创伤患者病理生理学的认识以及初始手术治疗的血流动力学和炎症后果,促使许多外科医生改变了对伴有骨盆或四肢损伤的严重多发伤患者的治疗方法,采用序贯治疗原则或创伤损害控制骨科(TDCO)。我们报告了一例涉及公共道路事故的患者,该患者因骨盆分离和髋关节脱位并伴有同侧肢体血管损伤,以休克状态入院。我们的治疗方法基于TDCO概念,在髋关节脱位复位后优先进行骨盆外固定。我们治疗方法的及时性使得肢体能够早期再血管化,同时避免了开放手术的血流动力学和炎症并发症。