Hemicorporectomy as a life-saving strategy for severe pelvic ring crush injury: a case report

Abstract

Hemicorporectomy is an ultra-radical surgery used only in extreme circumstances. Initially used for advanced pelvic neoplastic diseases and intractable pelvic infection, it may also be the only treatment option in patients with crushed pelvic trauma, in cases there are no reconstruction options. This procedure has a high mortality, and its success depends on the multidisciplinary approach, both in the initial phase and in the rehabilitation process. We present the case of a young patient with severe pelvic trauma that required a hemicorporectomy as the only treatment option and review of the literature.

Hemicorporectomía y equipamiento protésico. Reporte de un caso a los 15 años de seguimiento

“…La mayoría de los últimos estudios publicados incluyen pacientes con una patología traumática grave, grandes úlceras crónicas por decúbito u osteomielitis pélvica que no responden a ningún tipo de tratamiento. 9,16,17 Para lograr resultados exitosos con baja morbilidad y mortalidad, es esencial utilizar un enfoque multidisciplinario. Esto implica la coordinación de varios servicios quirúrgicos, como cirugía general, ortopedia, cirugía plástica, neurocirugía, urología y rehabilitación.…”

Hemicorporectomy as the Highest Grade of En Bloc Sacrectomy

“…S odstupem 10 dnů po hemikorporektomii jsme provedli revizi dorzální rány nad lumbální páteří pro suspektní likvoreu a pro jistotu jsme ještě jednou podvázali durální 8) navrhli modifikovaná indikační kritéria u pacientů s terminální pelvickou osteomyelitidou: 1. klinicky a obrazově (CT, MRI) ověřená diagnóza difuzní pelvické osteomyelitidy včetně biopsie, 2. předpoklad normálního života po hemikorporektomii a dosažení kvality života jako u pacienta s obdobnou invaliditou bez terminální pelvické osteomyelitidy, 3. schopnost pacienta pochopit a zvládnout fyzický, funkční a emoční handicap způsobený ztrátou dolní poloviny těla. Warr et al (19) publikovali v recentní práci hemikorporektomii provedenou pro otevřené poranění pánve. Ve stejné indikaci jsou dosud popsány pouze 3 případy (3,14,19), obecně z traumatické indikace 5 případů (15).…”

Open pelvic fracture with bilateral common iliac arteriovenous injury successfully treated with hemicorporectomy following damage control interventional radiology in a hybrid emergency room

“…It is mainly used for malignancy and intractable osteomyelitis in patients with spinal cord injury. 1,2 However, thus far, only three reports are present where hemicorporectomy was undertaken for trauma. The first case was reported by Baker et al, who described a successful case with a follow-up of 9 months, 3 the second was reported by Richardson et al, who described a patient with late mortality at 44 days after the initial trauma due to massive pulmonary bleeding secondary to Aspergillus infection, 4 and the third was reported by Warr et al, who described a successful case with a follow-up of 6 months.…”

“…The first case was reported by Baker et al, who described a successful case with a follow-up of 9 months, 3 the second was reported by Richardson et al, who described a patient with late mortality at 44 days after the initial trauma due to massive pulmonary bleeding secondary to Aspergillus infection, 4 and the third was reported by Warr et al, who described a successful case with a follow-up of 6 months. 2 The hybrid emergency room (HER), which has improved the survival rates of patients, was developed in Japan. This novel trauma care system allows clinicians to undertake life-saving procedures for severely injured patients, including whole-body computed tomography (CT) examination, damage control surgery, and transcatheter arterial embolization (TAE) by interventional radiology (IVR) on the same table in the same IVR-CT room without transferring the patient.…”

“…Hemicorporectomy or translumbar amputation requires resection of the pelvis and lower extremities, transection of the aorta, inferior vena cava, spinal cord, and urinary tract and digestive tract changes. It is mainly used for malignancy and intractable osteomyelitis in patients with spinal cord injury 1,2 . However, thus far, only three reports are present where hemicorporectomy was undertaken for trauma.…”