Klassifikation und Begriffsbestimmungen

Pohlemann, Tim; Regel, G.; Tscherne, H.

doi:10.1007/978-3-642-58841-9_4

Cited by 4 publications

(9 citation statements)

References 27 publications

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“…Our methodology was based on determining a summary of injury risks to those pelvic bony structures that are located within a 10 mm distance of vascular structures. A 10 mm or more spacing of fractures in the area of cancellous bone (regardless of whether it is the anterior or posterior arch of the pelvis) is regarded as a radiological sign of pelvic instability (Pohlemann et al, ; Tile et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…We evaluated only those arteries that can be identified during the CT angiography arterial phase and are in an intimate contact with the pelvic skeleton (within 10 mm distance). Their caliber usually varies from 1 to 2 mm, and we can expect a spontaneous closure due to the pressure of formed hematoma (Pohlemann et al, ; Tile et al, ); larger arteries injury needs to be closed by an intervention (vascular surgery or selective angioembolization).…”

Section: Discussionmentioning

confidence: 99%

“…The risk of arterial injury was assessed for each individual type of pelvic ring fracture based on the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification (Fig. ), which differentiates a stable injury with lesion sparing of the posterior arch (Type A), partially unstable injury with incomplete disruption of the posterior arch—unstable only in the horizontal plane (Type B), and unstable injury with complete disruption of the posterior arch—unstable in both the horizontal and vertical planes (Type C) (Pohlemann et al, ; Tile et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…The course of designated arteries within the pelvic region to the orientation of the dislocated fragments was correlated in order to evaluate the risk of arterial injury (positive contrast fluid extravasation after angiography or intraoperatively encountered bleeding artery) in relation to each specific type of pelvic fracture. Arteries running within 10 mm distance from the pelvic ring were considered as endangered to potentially caused injury by a dislocated larger than 10 mm sharp bony fragment in a suspected unstable pelvic injury (Pohlemann et al, ; Tile et al, ). Injuries of large veins and venous plexuses were not evaluated in this study.…”

Section: Methodsmentioning

confidence: 99%

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Where and what arteries are most likely injured with pelvic fractures?

et al. 2019

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Blood vessels passing through pelvic region come into intimate contact with pelvic bone and can be injured by the sharp edges of the dislocated fracture fragments. The aim of the study was to evaluate the influence of localization, shape, and dislocation of individual pelvic ring bones' fractures on arterial injuries. The study group consisted of 474 patients enrolled in a 1‐year prospective multicenter study. The pattern of pelvic fracture lines was characterized and recorded on a planar diagram of the subjected side of the pelvis. The diagram was subdivided into 11 designated areas. Frequency of injury at each 11 areas was recorded. The course of individual arteries in the 11 areas was also recorded in relation to each type of pelvic fractures. Out of the 474 investigated patients, the highest proportion of fractures occurred in the areas of the superior (62%) and inferior (59%) ramus of the pubis as well as in the lateral part of the sacrum (19%). These locations can be associated with injuries of the external iliac, obturator, internal iliac, and aberrant obturator arteries. The highest risk of arterial injuries was associated with vertically displaced fractures in the middle part of the superior and inferior pubic rami, along the ischial ramus, in the apex of the greater sciatic notch and in the vicinity of the ventral part of the sacroiliac joint, where the artery runs at a distance of less than 1 cm from the bone. Clin. Anat. 32:682–688, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Where and what arteries are most likely injured with pelvic fractures?

et al. 2019

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“…1 Furthermore, delayed wound débridement has been shown to directly contribute to sepsis and organ failure. 24,28,31 Immediate broad-spectrum antibiotic coverage (including anaerobics) and tetanus prophylaxis must be delivered as soon as possible for sepsis prevention.…”

Section: Figurementioning

confidence: 99%

Diagnosis and Management of Traumatic Hemipelvectomy

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Hess

Spitler

et al. 2022

J Am Acad Orthop Surg

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Traumatic hemipelvectomy (THP) is a catastrophic injury associated with high-energy trauma and high mortality. THP has been defined as a complete dislocation of the hemipelvis, often with disruption through the symphysis pubis and sacroiliac joint with concurrent traumatic rupture of the iliac vessels. Despite recent advances in prehospital resuscitative techniques, the true incidence of THP is difficult to ascertain because many patients die before hospital arrival. The leading causes of death associated with THP include blood loss, infection, and multiple system organ failure. Recognition and immediate intervention for these injuries is imperative for survival. The initial assessment includes a thorough physical examination assessing for signs of arterial damage and other associated injuries. Hemorrhage control and vigorous resuscitation should be prioritized to combat impending exsanguination. Emergent amputation has been found to be a lifesaving operation in these patients. The basis of this approach is rooted in achieving complete hemostasis while reducing complication rates. Understanding the nature of these massive pelvic injuries, the role of early amputation, and the importance of subspecialty communication can improve survivability and optimize patient outcomes.

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