Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지
DOI QR코드

DOI QR Code

The Management of Open Pelvic Fractures: A Report of 2 Cases

  • Yu, Byungchul (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Lee, Gil Jae (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Lee, Min A (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Choi, Kangkook (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Gwak, Jihun (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Park, Youngeun (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Yoon, Yong-Cheol (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Lee, Jungnam (Department of Trauma Surgery, Gachon University Gil Medical Center)
  • Received : 2020.03.04
  • Accepted : 2020.04.09
  • Published : 2020.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Open pelvic fractures are rare, but pose challenges for trauma surgeons due to their high morbidity and mortality. Generally, early death results from uncontrolled exsanguination and late death is related to pelvic sepsis. Therefore, management of these injuries should prioritize hemostasis and contamination control starting in the initial phase of treatment. We report two cases of unstable open pelvic fractures with perineal wounds that were managed successfully.

Keywords

References

  1. Grotz MR, Allami MK, Harwood P, Pape HC, Krettek C, Giannoudis PV. Open pelvic fractures: epidemiology, current concepts of management and outcome. Injury 2005;36:1-13. https://doi.org/10.1016/j.injury.2004.05.029
  2. Bircher M, Hargrove R. Is it possible to classify open fractures of the pelvis? Eur J Trauma 2004;30:74-9. https://doi.org/10.1007/s00068-004-1386-9
  3. Dente CJ, Feliciano DV, Rozycki GS, Wyrzykowski AD, Nicholas JM, Salomone JP, et al. The outcome of open pelvic fractures in the modern era. Am J Surg 2005;190:830-5.
  4. Dong Jl, Zhou DS. Management and outcome of open pelvic fractures: a retrospective study of 41 cases. Injury 2011;42:1003-7. https://doi.org/10.1016/j.injury.2011.01.032
  5. Hanson PB, Milne JC, Chapman MW. Open fractures of the pelvis. Review of 43 cases. J Bone Joint Surg Br 1991;73:325-9. https://doi.org/10.1302/0301-620X.73B2.2005166
  6. Lunsjo K, Abu-Zidan FM. Does colostomy prevent infection in open blunt pelvic fractures? A systematic review. J Trauma 2006;60:1145-8. https://doi.org/10.1097/01.ta.0000197615.31553.1e
  7. Faringer PD, Mullins RJ, Feliciano PD, Duwelius PJ, Trunkey DD. Selective fecal diversion in complex open pelvic fractures from blunt trauma. Arch Surg 1994;129:958-63; discussion 963-4. https://doi.org/10.1001/archsurg.1994.01420330072014
  8. Petrone P, Inaba K, Wasserberg N, Teixeira PG, Sarkisyan G, Dubose JJ, et al. Perineal injuries at a large urban trauma center: injury patterns and outcomes. Am Surg 2009;75:317-20. https://doi.org/10.1177/000313480907500410
  9. Brenneman FD, Katyal D, Boulanger BR, Tile M, Redelmeier DA. Long-term outcomes in open pelvic fractures. J Trauma 1997;42:773-7. https://doi.org/10.1097/00005373-199705000-00003
  10. Fallon WF. The present role of colostomy in the management of trauma. Dis Colon Rectum 1992;35:1094-102. https://doi.org/10.1007/BF02253003
  11. Sola JE, Bender JS, Buchman TG. Morbidity and timing of colostomy closure in trauma patients. Injury 1993;24:438-40. https://doi.org/10.1016/0020-1383(93)90143-T
  12. Law WL, Chu KW, Choi HK. Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision. Br J Surg 2002;89:704-8. https://doi.org/10.1046/j.1365-2168.2002.02082.x
  13. Grotz MR, Allami MK, Harwood P, Pape HC, Krettek C, Giannoudis PV. Open pelvic fractures: epidemiology, current concepts of management and outcome. Injury 2005;36:1-13. https://doi.org/10.1016/j.injury.2004.05.029
  14. Tang P, Meredick R, Prayson MJ, Gruen G. External fixation of the pelvis. Tech Orthop 2002;17:228-38. https://doi.org/10.1097/00013611-200206000-00012
  15. Leenen LP, van der Werken C, Schoots F, Goris RJ. Internal fixation of open unstable pelvic fractures. J Trauma 1993;35:220-5. https://doi.org/10.1097/00005373-199308000-00008