Moss M C, Bircher M D
Department of Orthopaedic Surgery, St. George's Hospital, London, England.
Injury. 1996;27 Suppl 1:S-A21-3. doi: 10.1016/0020-1383(96)83790-9.
Fractures of the pelvis are not only common but are very varied in their complexity. They represent 3% of all fractures (1), they account for 1 in every 1000 surgical admissions and are the third most commonly encountered injury in motor vehicle accident fatalities (2). However, only a small percentage of all pelvic fractures are associated with major disruption of the pelvic ring (3). Life threatening haemorrhage is a frequent complication of major pelvic fractures (1, 4) and haemorrhage is the leading cause of death in these patients (5, 6). It was believed that fracture and subsequent displacement of the ring greatly increased pelvic volume. However, clinical practice seemed to indicate that this might not be true. This study aimed to assess the change in pelvic volume which occurs in severely displaced pelvic fractures. A model of the bony pelvis was designed to permit extreme displacements of the symphyseal and sacroiliac joints. The volume of a polythene balloon placed within the true pelvis was measured as an indication of true pelvic volume. Our finding was that the increase in the volume of the true pelvis which occurs in a fracture with massive diastasis is much smaller than previously assumed.
骨盆骨折不仅常见，而且其复杂程度差异很大。它们占所有骨折的3%（1），每1000例外科住院病例中就有1例骨盆骨折，并且是机动车事故死亡中第三常见的损伤（2）。然而，在所有骨盆骨折中，只有一小部分与骨盆环的严重破坏有关（3）。危及生命的出血是严重骨盆骨折常见的并发症（1,4），出血是这些患者死亡的主要原因（5,6）。过去认为骨盆环骨折及随后的移位会使骨盆容积大幅增加。然而，临床实践似乎表明情况可能并非如此。本研究旨在评估严重移位骨盆骨折时骨盆容积的变化。设计了一个骨盆骨骼模型，以允许耻骨联合和骶髂关节发生极端移位。测量置于真骨盆内的聚乙烯球囊的容积，以此作为真骨盆容积的指标。我们的研究结果是，在伴有大量分离移位的骨折中，真骨盆容积的增加比之前设想的要小得多。
