van Veen I H, van Leeuwen A A, van Popta T, van Luyt P A, Bode P J, van Vugt A B
Department of General Surgery and Traumatology, University Hospital of Leiden, The Netherlands.
Injury. 1995 Mar;26(2):81-5. doi: 10.1016/0020-1383(95)92181-9.
Thirty-nine patients with unstable pelvic fractures were analysed retrospectively. The mean age of the group was 41 years (range 15-77). Of these cases 35 had sustained high energy trauma. The mean Hospital Trauma Index-Injury Severity Score of the population was 32 (16-66). Nine cases were haemodynamically unstable on admission. The type of unstable pelvic fracture was classified according to Tile. Sixteen patients had a type B fracture and 23 had a vertical instability (type C) fracture. In two patients, an open fracture was seen. Directly associated injuries were diagnosed in 11 patients, of which eight showed damage of the urogenital system, three of the rectum and three of the peripheral nerve system. In seven cases the fracture was treated non-operatively; in the remaining 32 patients the pelvic ring was stabilized operatively. Additional therapy for hypovolaemic shock due to pelvic bleeding was necessary in six cases. The overall mortality in this series was 13 per cent. Early and aggressive resuscitation and standardized treatment in well-equipped and staffed injury centres is mandatory in these severely traumatized patients to achieve optimal results and to minimize the risk of fatal outcome.
对39例不稳定骨盆骨折患者进行回顾性分析。该组患者的平均年龄为41岁（范围15 - 77岁）。其中35例遭受高能量创伤。该人群的平均医院创伤指数-损伤严重度评分是32（16 - 66）。9例患者入院时血流动力学不稳定。不稳定骨盆骨折的类型根据Tile分类法进行分类。16例患者为B型骨折，23例为垂直不稳定（C型）骨折。2例患者出现开放性骨折。11例患者诊断出直接相关损伤，其中8例显示泌尿生殖系统损伤，3例直肠损伤，3例周围神经系统损伤。7例骨折采用非手术治疗；其余32例患者骨盆环通过手术稳定。6例患者因骨盆出血需要对低血容量性休克进行额外治疗。该系列的总体死亡率为13%。对于这些严重创伤患者，在设备完善、人员配备充足的创伤中心进行早期积极复苏和标准化治疗是必要的，以获得最佳结果并将致命结局的风险降至最低。
