Traumatic hemipelvectomy: A report of successful reimplantation

Osti, Michael; Mittler, Christoph; Putzke, Matthias; Benedetto, K. P.

doi:10.1016/j.injury.2006.06.022

Cited by 16 publications

(15 citation statements)

References 9 publications

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“…The disability resulting from orthopedic pathologies is very significant [34]. As to the loss of the lower limb what should be considered in this case is not only the lack of the limb itself (as write Walcher et al [35] and as has already been described by Osti et al [36] "a leg, even if numb and paralytic, is still useful for sexual, urinary and anal functioning and has a significant impact on psychological adjustment"), but also the impossibility of movement and lack of stability in an upright position and in sitting. Indeed, in such conditions the lack of the limb requires 45% more energy than for the able-bodied [12].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Hemipelvectomy: Surgical and Medical-Legal Aspects

Ricci¹

2014

Journal of Forensic Biomechanics

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Background: Traffic accidents are major causes of disability and mortality due to the increasing number of vehicles, changes in lifestyle and high-risk behavior among the general population. Traumatic hemipelvectomy is a type of exceptional lesion representing 0.6% of all pelvic fractures, although lesions of the lower extremities are more usual than those of the upper extremities. Case presentation: The authors present an unusual case of traumatic left hemipelvectomy, and consider the medical-legal aspects resulting from an accident of a motorcycle driver, which involved a lateral collision between the subject's motorcycle and a car. Conclusion: With traumatic hemipelvectomy in young subjects difficulties arise at any level and in all medical fields: clinically, surgical and medicolegal

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Section: Discussionmentioning

confidence: 99%

Traumatic Hemipelvectomy: Surgical and Medical-Legal Aspects

Ricci¹

2014

Journal of Forensic Biomechanics

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“…Pohlemann [12] attempted to salvage the limb in four cases of traumatic hemipelvectomy, 3 of them died and the remaining case had to eventually undergo amputation. Up to now, there was only one case of closed traumatic hemipelvectomy, reported by Osti [2], in which a partial success with limb salvage was achieved. However, this patient underwent below knee amputation as a result of muscle necrosis, and the remaining stump had neither sensory nor motor function.…”

Section: Discussionmentioning

confidence: 99%

“…It is rarely seen in clinical practice because only a small number of cases can be survival and are transfered to the hospital. From 1915, when the first case of traumatic hemipelvectomy was successfully treated [1], there have been increasing numbers of cases were reported to be successfully treated [2-4]. A total of seven cases with traumatic hemipelvectomy were treated in our hospital from June 21, 2002 to September 3, 2011.…”

Section: Introductionmentioning

confidence: 99%

Management of traumatic hemipelvectomy: an institutional experience on four consecutive cases

Zhang

et al. 2013

Scand J Trauma Resusc Emerg Med

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Background and objectiveThe incidence of traumatic hemipelvectomy is rare, but it is a devastating injury. Recently, an increasing number of patients with traumatic hemipelvectomy are admitted to trauma centers alive due to improvements of the pre-hospital care. Successful management requires prompt recognition of the nature of this injury and meticulous surgical technique. We present our successful experiences on four cases of traumatic hemipelvectomy in the past nine years.Patients and methodsFour cases with traumatic hemipelvectomy were admited to our hospital from June 21, 2002 to September 3, 2011. All injuries occurred due to vehicle accident and all patients were in a state of severe hypotension, with two of them having anal lacerations. These four cases were treated immediately with resuscitation, control of hemorrhage, early amputation, repeated debridement and closure of the wounds. An angiographic embolization was given to control hemorrhage in two of the cases preoperatively. One case underwent fecal diversion. Wound infection occurred in all of cases which was successfully controlled by repeated debridements, effective anti-biotic regimen, split-thickness skin grafts.ResultsAll four cases were saved successfully with well-healed wounds during follow up from 1 to 7 years. They were able to walk by themself using crutches.ConclusionAdhering to the surgery principles of damage control including appropriate resuscitation, hemorrhage control, coagulopathy correction and multiple debridements and closure of the wounds in reasonable period of time can save the life of cases suffering from severe pelvic ring injury.

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“…At this time, there is only one other case report of total reconstruction by means of vascular prosthesis from the common iliac artery and vein in one patient without visceral injuries [12].…”

Section: Discussionmentioning

confidence: 99%