Smith Max, Lewis Joseph R, Bolling Taryn, Brick Scott, Leach Patrick
Medical School, Kansas City University, Kansas City, USA.
Department of Trauma and Acute Care Surgery, Lee Health, Gulf Coast Medical Center, Fort Myers, USA.
Cureus. 2025 Feb 16;17(2):e79095. doi: 10.7759/cureus.79095. eCollection 2025 Feb.
Traumatic hemipelvectomy (THP) is a rare, life-threatening injury characterized by the dislocation of the hemipelvis, often resulting from high-energy trauma. It carries a high mortality risk due to severe vascular injuries, with survival contingent on rapid hemorrhage control and a multidisciplinary approach. Limb salvage is rarely achievable due to the extent of the injury and complications such as infection and tissue nonviability. We present a case of incomplete THP in a 29-year-old woman who sustained severe soft tissue, bony, and vascular injuries following a boating accident. On arrival, the patient was in critical condition with a massive hemorrhage, requiring immediate intervention. A multidisciplinary approach was implemented, including damage control surgery, vascular ligation, massive transfusion protocol (MTP), and selective embolization. Despite initial efforts, her left lower extremity was deemed unsalvageable, and a left hemipelvectomy was performed. Postoperative care involved managing pedicle flap congestion with sequential wound debridement and hyperbaric oxygen therapy. The patient's recovery included multiple surgical interventions for wound care and flap viability. Over time, viable tissue demarcation allowed for more definitive closure. This case underscores the complexity of managing THP, highlighting the importance of timely, coordinated surgical efforts, aggressive hemorrhage control, and postoperative care to prevent infection and optimize functional outcomes.
创伤性半骨盆切除术（THP）是一种罕见的、危及生命的损伤，其特征为半骨盆脱位，通常由高能创伤导致。由于严重的血管损伤，它具有很高的死亡风险，生存取决于迅速控制出血和多学科方法。由于损伤程度以及感染和组织失活等并发症，保肢很少能够实现。我们报告一例29岁女性的不完全THP病例，该患者在一次 boating accident后遭受了严重的软组织、骨骼和血管损伤。到达时，患者处于危急状态，大量出血，需要立即干预。实施了多学科方法，包括损伤控制手术、血管结扎、大量输血方案（MTP）和选择性栓塞。尽管最初进行了努力，但她的左下肢被认为无法挽救，遂进行了左半骨盆切除术。术后护理包括通过连续伤口清创和高压氧治疗来处理蒂皮瓣充血。患者的康复包括多次用于伤口护理和皮瓣存活的手术干预。随着时间的推移，存活组织的分界使得更确切的闭合成为可能。该病例强调了管理THP的复杂性，突出了及时、协调的手术努力、积极控制出血以及术后护理以预防感染和优化功能结果的重要性。
原文中“boating accident”可能有误，你可根据实际情况修正，这里暂按此翻译。
