Tile M
Orthop Clin North Am. 1980 Jul;11(3):423-64.
These most difficult patients require an expert early general assessment and rapid resuscitation. We have suggested a treatment algorithm that has helped us in managing these patients. The degree of posterior instability in the initial radiographs of the pelvis is of considerable prognostic value. The patient's bone injury should be rapidly assessed by history, physical examination, and radiological examination, and treatment should progress in a logical fashion on the basis of that assessment. We have found the use of the external skeletal fixator to be helpful in some types of pelvic injury. One must remember, however, that the present external fixators that fix the anterior hemipelvis only may produce increased deformity across the posterior structures in cases of posterior instability of the ring. Refinements in technique may eventually solve that problem. Further research into pelvic biomechanics is required to improve our methods of management of these difficult patients.
这些最难处理的患者需要专家进行早期全面评估和快速复苏。我们提出了一种治疗方案，这对我们处理这些患者很有帮助。骨盆初始X线片上后方不稳定的程度具有相当大的预后价值。应通过病史、体格检查和影像学检查快速评估患者的骨损伤情况，并在此评估基础上按合理的方式进行治疗。我们发现，外骨骼固定器在某些类型的骨盆损伤中很有用。然而，必须记住，目前仅固定前半骨盆的外固定器在骨盆环后方不稳定的情况下可能会导致后方结构的畸形增加。技术的改进最终可能会解决这个问题。需要对骨盆生物力学进行进一步研究，以改进我们对这些棘手患者的处理方法。
