Kleweno Conor P, Scolaro John, Sciadini Marcus F, McAlister Ian, Shannon Steven F, Chip Routt M L
Instr Course Lect. 2020;69:489-506.
Pelvic fractures are often the result of high-energy trauma and can result in significant morbidity. Initial management is focused on patient resuscitation and stabilization given the potential for life-threatening hemorrhage that is associated with these injuries. Radiographic evaluation and classification of the pelvic injury guides initial management, provisional stabilization, and preoperative surgical planning. Definitive reduction and fixation of the posterior and anterior pelvic ring is sequentially performed to restore stability and allow for mobilization and healing. Open techniques are commonly used for the pubic symphysis and displaced anterior and posterior ring injuries for which an acceptable reduction is unable to be obtained with closed or indirect techniques. Percutaneous fixation has become increasingly more common for both the anterior and posterior ring and utilizes screw placement within the osseous fixation pathways of the pelvis.
骨盆骨折通常是高能量创伤的结果，可导致严重的发病率。鉴于这些损伤可能伴有危及生命的出血，初始治疗重点是患者的复苏和稳定。骨盆损伤的影像学评估和分类指导初始治疗、临时稳定以及术前手术规划。依次对骨盆前后环进行确定性复位和固定，以恢复稳定性并促进活动和愈合。开放技术通常用于耻骨联合以及移位的前后环损伤，对于这些损伤，采用闭合或间接技术无法获得可接受的复位。经皮固定在骨盆前后环中越来越普遍，它利用在骨盆骨固定通道内拧入螺钉。
