Complex Pelvic Fractures: Emergency Room to Internal Fixation - A Case Series And Literature Review
Journal Title: Journal of Pakistan Orthopaedic Association - Year 2020, Vol 32, Issue 02
Abstract
A complex pelvic fracture is defined as a pelvic fracture that occurs together with an additional organ injury in the pelvic region, and includes urogenital, gastrointestinal, neurological and retroperitineal vessel injury. Besides these additional organ injuries, complex pelvic fractures are almost always unstable. The orthopedic surgeon managing complex unstable pelvic fractures must conceptually divide their management into the measures taken in the Emergency room setting, intermin measures, and definitive measures aimed to restore pelvic stability. Regarding Emergency room measures, circumferential sheeting, external pelvic fixation device, and the pelvic C-clamp, are all acceptable measures employed as part of patient resuscitation. The more historial pelvic sling, and frequently used external pelvic fixation device are both acceptable intermediate stabilization measures. Definitive management is reserved for unstable pelvic fractures where anatomical alignment cannot be achieved by external means. The complications of prolonged external pelvic fixation is however appreciated, and in centers experienced in the technique, internal plating fixation is preferred. We reported a series of two patients with complex unstable pelvic fractures, further complicated by acetabular fractures that were ultimately managed by internal fixation and a total hip replacement. Our case series followed these two patients from the emergency room setting until their definitive internal plate fixation and concluded by an evaluation of functional outcome assessed with Majeed score. The essential principles in the management of these patients are highlighted together with the frequent complications reported and our series is valuable to those orthopedic surgeons involved in the management of these challenging patients.
Authors and Affiliations
Aftab Younus1, Adrian Kelly2, Muhammad Siddique Hamid3, Muhammad Tariq Sohail4, EjazAhmad5
Radial Length and Radial Angle in Closed Reduction Plaster Cast Immobilization Versus External Fixation in Comminuted Intra Articular Fracure of Distal Radius
To compare mean difference in radial length and radial angle in closed reduction and plaster cast immobilization versus external fixation in comminuted intra articular fractures of distal radius and to determine union ra...
Outcome of Schatzkar Type VI Tibial Plateau Fractures Treated with Ilizarov External Fixator
Objective: To analyze the results of schtzkar type VI tibial fractures treated with ilizarov external fixator. Methods: This study was conducted at Mardan Medical Complex from January 2015 to December 2017.All patient...
Pakistan Orthopaedic Association (POA): A Quantum Leap towards excellence in Orthopaedic Care
It is a matter of honour for me to write this editorial for Journal of Pakistan Orthopaedic Association (JPOA). In my short carrier of more than two decades in Pakistan, I have seen Orthopaedic grow from trauma service a...
Embracing Cultural Sensitivity in Pediatric Orthopedic Care in Pakistan
The healthcare landscape in Pakistan is as complex as its rich cultural tapestry. For pediatric orthopedic conditions, cultural beliefs and practices significantly influence medical decisions. This editorial emphasizes...
Outcome of AO Type C Fractures Distal Radius treated with Volar Locking Plates in a Tertiary care center Lahore
Objective: To determine the clinical and radiological outcome of AO Type C fracture distal radius treated with 2.4mm Titanium volar locking plates. Methods: This descriptive study was conducted in Department of Hand a...