Abstract:

Objective

To study the therapeutic effect of treating patients of hemodynamically unstable pelvic fractures combined with abdominal organ injuries.

Methods

The clinical data of thirty-two patients admitted to our hospital from June 2009 to September 2014 with hemodynamically unstable pelvic fracture combined with abdominal organ injury were collected in the follow-up study. The mean ISS was 36.1(35.2±2.94). All 32 patients were treated with the integrated pre-hospital and inhospital Damage Control Orthopedics Model, including packing hemostasis, simple surgical repair,colostomy, etc. In the secondary union when the patients were in the stable condition, deterministic internal fixation and definitive operation for abdominal organs were applied. The salvage rate, death rate,complication incidence and curative effect incidences were calculated.

Results

Five patients died and the death rate was 15.62%. Six patients (18.75%) suffered from severe complications. Twenty-four pa tients, after deterministic internal fixation, were in a favorable postoperative recovery; among them, 2 were in poor wound healing. All the patients undergoing the reconstructive surgery for abdominal organs in the secondary union recovered well during the perioperative period and had no severe complications.

Conclusions

Hemodynamically unstable pelvic fractures combined with abdominal organ injuries can be life-threatening and require complex treatments. The integrated pre-hospital and in-hospital Damage Control Orthopedics and inter-disciplinary cooperation are important requirements for management and successful treatment.

Key words: Abdominal organ injury, Shock, Fracture fixation, Damage Control Orthopedics