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骨盆创伤后不对称:评估与序贯治疗

Pelvic post-traumatic asymmetry: Assessment and sequenced treatment.

作者信息

Cano-Luís Pedro, Giráldez-Sánchez Miguel Ángel, Andrés-Cano Pablo

机构信息

Orthopaedic Surgery and Traumatology Department, Hospital Universitario Virgen del Rocío, Spain.

出版信息

EFORT Open Rev. 2018 May 21;3(5):335-346. doi: 10.1302/2058-5241.3.170069. eCollection 2018 May.

Abstract

The most common cause of post-traumatic pelvic asymmetry is, by far, initial nonoperative treatment.Open reduction and internal fixation of unstable pelvic fractures are recommended to avoid pelvic nonunion or subsequent structural deformities.The most common symptom is pelvic pain. Pelvic instability is another symptom, as well as persistent urogenital problems and neurological sequelae.Preoperative evaluation of these patients requires careful clinical and functional assessment, in addition to a complete radiological study.Surgical treatment of pelvic fracture nonunions is technically demanding and has potentially serious complications.We have developed a new classification that modifies and completes Mears and Velyvis's classification in which we highlight two types of post-traumatic sequelae with different clinical conditions and whose basic differentiating element is whether pelvic deformity is present or not. Based on this classification, we have established our strategy of surgical treatment. Cite this article: 2018;3 DOI: 10.1302/2058-5241.3.170069.

摘要

到目前为止,创伤后骨盆不对称最常见的原因是最初的非手术治疗。对于不稳定骨盆骨折,建议进行切开复位内固定,以避免骨盆不愈合或随后的结构畸形。最常见的症状是骨盆疼痛。骨盆不稳定是另一个症状,还有持续的泌尿生殖系统问题和神经后遗症。对这些患者进行术前评估,除了完整的放射学检查外,还需要仔细的临床和功能评估。骨盆骨折不愈合的手术治疗技术要求高,且有潜在的严重并发症。我们制定了一种新的分类方法,对米尔斯(Mears)和韦利维斯(Velyvis)的分类进行了修改和完善,在该分类中,我们突出了两种具有不同临床情况的创伤后后遗症,其基本区分要素是是否存在骨盆畸形。基于这一分类,我们确立了手术治疗策略。引用本文:2018;3 DOI: 10.1302/2058 - 5241.3.170069。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/226f/5994633/115d9a119b13/eor-3-335-g001.jpg

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