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成人骨盆骨折及相关损伤的重要性——当前的多学科方法

Pelvic Fractures in Adults and the Importance of Associated Injuries-A Current Multi-Disciplinary Approach.

作者信息

Ohla Jakub, Walus Piotr, Wiciński Michał, Małkowski Bartłomiej, Turoń Bartosz, Jabłoński Adam, Gawryjołek Michał, Kellett Katie, Zabrzyński Jan

机构信息

Department of Orthopaedics and Traumatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Jan Kochanowski University in Kielce, 25-001 Kielce, Poland.

出版信息

Clin Pract. 2025 Jul 11;15(7):130. doi: 10.3390/clinpract15070130.

DOI:10.3390/clinpract15070130
PMID:40710040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12294093/
Abstract

BACKGROUND

Pelvic ring fractures are a significant and growing health problem in the field of trauma and orthopedic surgery. The aim of this paper was to present a concise description of these musculoskeletal injuries, available classification systems, and vascular and genitourinary complications.

RESULTS

The most common complications of serious pelvic ring fractures are arterial and venous hemorrhages, as well as urethral injuries. Arterial hemorrhages most often originate from the trunk or branches of the iliac artery, and the standard treatment is pelvic stabilization and implementation of intravascular procedures. In the case of venous hemorrhages, peritoneal pelvic packing is the most important.

CONCLUSIONS

A multi-disciplinary approach and treatment algorithmization are important to facilitate the prioritization of therapeutic procedures. Treatment of patients with pelvic ring fractures should take place in specialized trauma centers.

摘要

背景

骨盆环骨折在创伤和骨科手术领域是一个重大且日益严重的健康问题。本文旨在简要描述这些肌肉骨骼损伤、现有的分类系统以及血管和泌尿生殖系统并发症。

结果

严重骨盆环骨折最常见的并发症是动脉和静脉出血以及尿道损伤。动脉出血最常源于髂动脉主干或分支,标准治疗方法是骨盆固定和血管内操作。对于静脉出血,盆腔腹膜填塞是最重要的。

结论

多学科方法和治疗流程化对于促进治疗程序的优先排序很重要。骨盆环骨折患者的治疗应在专门的创伤中心进行。

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本文引用的文献

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Factors Associated With Infection in Patients With Combined Pelvic Ring and Bladder Injuries.与骨盆环合并膀胱损伤患者感染相关的因素。
J Orthop Trauma. 2024 Sep 1;38(9):459-465. doi: 10.1097/BOT.0000000000002846.
2
Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries?骨盆环骨折前路固定是否会增加合并膀胱或尿道损伤患者的感染风险?
J Orthop Trauma. 2024 Mar 1;38(3):129-133. doi: 10.1097/BOT.0000000000002745.
3
Superior gluteal artery injury in pelvic ring injury and acetabular fracture: Single center observational study.骨盆环损伤和髋臼骨折中的臀上动脉损伤:单中心观察性研究。
J Orthop Sci. 2024 Nov;29(6):1483-1488. doi: 10.1016/j.jos.2023.10.007. Epub 2023 Oct 20.
4
Pediatric Pelvic and Acetabular Fractures: Discerning Severity by Classification and Clinical Management.小儿骨盆与髋臼骨折:通过分类和临床管理辨别严重程度
J Pediatr Orthop. 2023 Aug 1;43(7):424-430. doi: 10.1097/BPO.0000000000002426. Epub 2023 May 3.
5
Angioembolization in Severe Pelvic Trauma is Associated with Venous Thromboembolism.严重骨盆创伤中的血管栓塞术与静脉血栓栓塞症有关。
J Surg Res. 2023 Mar;283:540-549. doi: 10.1016/j.jss.2022.10.054. Epub 2022 Nov 25.
6
Common and uncommon vascular injuries and endovascular treatment associated with pelvic blunt trauma: a real-world experience.常见和不常见的血管损伤与骨盆钝性创伤相关:真实世界的经验。
Jpn J Radiol. 2023 Mar;41(3):258-265. doi: 10.1007/s11604-022-01355-1. Epub 2022 Nov 9.
7
Epidemiology of high-energy blunt pelvic ring injuries: A three-year retrospective case series in a level-I trauma center.高能钝性骨盆环损伤的流行病学:一级创伤中心的三年回顾性病例系列。
Orthop Traumatol Surg Res. 2023 Apr;109(2):103446. doi: 10.1016/j.otsr.2022.103446. Epub 2022 Oct 18.
8
Retrospective observational study correlating traumatic pelvic fractures and their associated injuries according to the Tile classification.回顾性观察研究根据Tile 分类,对创伤性骨盆骨折及其相关损伤进行相关性分析。
Cir Esp (Engl Ed). 2023 Aug;101(8):548-554. doi: 10.1016/j.cireng.2022.10.004. Epub 2022 Oct 17.
9
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Eur J Orthop Surg Traumatol. 2023 Jul;33(5):1515-1521. doi: 10.1007/s00590-022-03388-8. Epub 2022 Oct 9.
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