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用于不稳定骨盆环损伤急诊治疗的骨盆C形夹。30例临床经验报告。

The pelvic C-clamp for the emergency treatment of unstable pelvic ring injuries. A report on clinical experience of 30 cases.

作者信息

Heini P F, Witt J, Ganz R

机构信息

Department of Orthopaedic Surgery, University of Berne, Switzerland.

出版信息

Injury. 1996;27 Suppl 1:S-A38-45. doi: 10.1016/0020-1383(96)83793-4.

Abstract

An unstable pelvic ring injury was stabilized with the AO C-clamp in thirty multiply injured patients. The average ISS was 29 (19-57). Transfusions totalled 24 units of blood/fresh frozen plasma/platelets (0-117) on average. In 12 cases, the application was for an unstable fracture alone, in 18 patients there was an unstable haemodynamic situation in addition. The application was haemodynamically effective in 10 cases. In 66% of cases, the initial reduction was good and the anatomy of the pelvic ring was adequately restored. Ten patients (33%) died; five during the first hours after admission due to haemorrhagic shock; the remaining five from multiple organ failure, fat embolism and head injury. Definitive stabilization was accomplished after 4.5 days on average (0-15). Complications relating directly to the clamp did not occur. The application of the C-clamp has a clear place in the management of polytraumatized patients with linear unstable pelvic ring injuries.

摘要

在30例多发伤患者中,使用AO C形钳稳定不稳定的骨盆环损伤。平均损伤严重度评分(ISS)为29(19 - 57)。平均输血总量为24单位血液/新鲜冰冻血浆/血小板(0 - 117)。12例仅用于不稳定骨折,18例患者还存在不稳定的血流动力学情况。该应用在10例患者中血流动力学效果良好。66%的病例初始复位良好,骨盆环解剖结构得到充分恢复。10例患者(33%)死亡;5例在入院后数小时内因失血性休克死亡;其余5例死于多器官功能衰竭、脂肪栓塞和头部损伤。平均4.5天(0 - 15天)后完成确定性固定。未发生与C形钳直接相关的并发症。C形钳在伴有线性不稳定骨盆环损伤的多发伤患者的治疗中具有明确的作用。

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