Treatment of Vertically Unstable Pelvic Ring Injuries in Patients with Complicated Pelvic Trauma

Abstract

The purpose of the work was to improve the treatment results for patients with complicated pelvic injury using differentiated application of transosseous and internal osteosynthesis. Retrospective analysis of treatment results is presented for 52 patients with vertically unstable pelvic ring injuries and concomitant abdominal injuries. Clinical cases demonstrate the variants of clinical decision depending on the type of injury, degree of pelvic ring instability, pattern of concomitant abdominal injuries. Protocol of patient management in such injuries is suggested.

Review of the Problems of Diagnosis of Endopelvic Haemorrhage, Its Intensity, Volume, and Duration, and Treatment Methods of Circulatory Injuries and Surgical Hemostasis after Pelvic Fractures

“…In other clinical situations it is necessary to use core-type devices for outer fixation of pelvis that allows stable fixation of only front part in most cases [44, 55].…”

“…The points of massive haemorrhages in retroperitoneal space and endopelvic fiber are frequently the damaged great endopelvic vessels, presacral and perivesical venous plexuses, and major vessels of the spongy pelvic bone [14, 41–43]. Damage of various vessels occurs in 22,1-30% of cases; thus, damage of arteries and great veins is often diagnosed in lethal cases [41, 44].…”