Gänsslen A, Pohlemann T, Paul C, Lobenhoffer P, Tscherne H
Unfallchirurgische Klinik der Medizinischen Hochschule Hannover, Germany.
Injury. 1996;27 Suppl 1:S-A13-20.
3260 patients with pelvic and acetabular fractures were assessed using a standardized documentation form by collating the data on 1905 patients treated at the Department of Traumatology of the Hannover Medical School together with those patients treated between 1991 and 1993 in the German Multicentre Study Group (Pelvis) of the German Trauma Society and the German Section of the AO International. 2551 patients had pelvic ring injuries. 61.7% of the patients were multiply injured. 12.2% were suffering a complex pelvic trauma defined as a pelvic injury with concomitant soft tissue injury. The pelvic ring fracture was classified as stable in 54.8% (type A injury), as rotationally unstable in 24.7% (type B injury), and as unstable in translation in 20.5% (type C injury). There were concomitant acetabular fractures in 15.7%. The most frequent single lesions affecting the pelvic girdle were fractures of the ischiopubic bones (transpubic instability), injuries involving the sacroiliac joint (transiliosacral instability), and sacral fractures (transsacral instability). The overall rate of operative stabilizations was 21.6%. Type B injuries were stabilized in 28.9% and type C injuries in 46.7%. The overall mortality rate was 13.4%, depending significantly on the associated extrapelvic trauma. In complex pelvic injuries, the mortality rate was 31.1% whereas for pelvic fractures without concomitant soft tissue injury the rate was only 10.8%.
采用标准化记录表格，对3260例骨盆和髋臼骨折患者进行了评估，数据来自汉诺威医学院创伤科治疗的1905例患者，以及1991年至1993年期间德国创伤协会德国多中心研究组（骨盆）和AO国际德国分部治疗的患者。2551例患者存在骨盆环损伤。61.7%的患者为多发伤。12.2%的患者遭受复杂骨盆创伤，定义为伴有软组织损伤的骨盆损伤。骨盆环骨折中，54.8%为稳定型（A型损伤），24.7%为旋转不稳定型（B型损伤），20.5%为垂直不稳定型（C型损伤）。15.7%的患者伴有髋臼骨折。影响骨盆带最常见的单一损伤是耻骨坐骨支骨折（耻骨联合不稳定）、骶髂关节损伤（骶髂关节不稳定）和骶骨骨折（经骶骨不稳定）。手术稳定治疗的总体比例为21.6%。B型损伤的稳定治疗比例为28.9%，C型损伤为46.�%。总体死亡率为13.4%，显著取决于合并的骨盆外创伤。在复杂骨盆损伤中，死亡率为31.1%，而无软组织损伤的骨盆骨折死亡率仅为10.8%。
