Marmor Meir, El Naga Ashraf N, Barker Jordan, Matz Jacob, Stergiadou Styliani, Miclau Theodore
Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, CA, United States.
Faculty of Medicine, University of Thessaly, Larissa, Greece.
Front Surg. 2020 Nov 12;7:588845. doi: 10.3389/fsurg.2020.588845. eCollection 2020.
Pelvic ring injuries (PRI) are among the most difficult injuries to deal with in orthopedic trauma. When these injuries are accompanied by hemodynamic instability their management becomes significantly more complex. A methodical assessment and expeditious triage are required for these patients followed by adequate resuscitation. A major triage decision is whether these patients should undergo arterial embolization in the angiography suit or prompt packing and pelvic stabilization in the operating room. Patient characteristics, fracture type and injury characteristics are taken into consideration in the decision-making process. In this review we discuss the acute evaluation, triage and management of PRIs associated with hemodynamic instability. An evidence based and protocol driven approach is necessary in order to achieve optimal outcomes in these patients.
骨盆环损伤（PRI）是骨科创伤中最难处理的损伤之一。当这些损伤伴有血流动力学不稳定时，其处理会变得显著更加复杂。对于这些患者，需要进行系统评估和快速分诊，随后进行充分的复苏。一个主要的分诊决策是这些患者应在血管造影室接受动脉栓塞，还是在手术室迅速进行填塞和骨盆稳定手术。在决策过程中会考虑患者特征、骨折类型和损伤特点。在本综述中，我们讨论与血流动力学不稳定相关的骨盆环损伤的急性评估、分诊和处理。为了使这些患者获得最佳治疗效果，采用基于证据和方案驱动的方法是必要的。
