Modern approaches in pelvic fractures management

Abstract

Background. Occurring in 3-10% of all fractures, pelvic injuries require some complex management techniques in trauma care. They usually occur in young persons due to high-energy trauma and can be fatal. The multidisciplinary approach in pelvic trauma management is necessary. Objective of the study. To study the treatment tactics in different types of pelvic fractures. Material and Methods. The study included retrospective data analysis of 52 patients with pelvic fractures treated in the Institute of Emergency Medicine. There were 24(46%) men and 28(54%) women. Patient age ranged from 21 to 92, mean age-51.79 years. Сauses of trauma: traffic road accident-21 (40%), habitual-28 (54%), during childbirth-2 (4%), fall-1 (2%). Fracture type: A-40, B-7, C-5. cases. Results. Complex management included physical exam, laboratory tests, X-ray, CT and individual tactics of treatment was applied to each patient. In the majority of cases (86,53%) conservative treatment was indicated: Volcovici positioning - 40 cases (76%), skeletal traction - 4 cases (9%), Revenco positioning-1 case. Surgical treatment was performed in unstable pelvic fractures -7 cases (3%); external fixation-5 cases, internal osteosynthesis-2 cases. All surgical interventions were performed during the first week after trauma, mostly in 1-2 days. Conclusion. Treatment of pelvic fractures should be individual and depends on fracture type, associated injuries, patient age, general condition. Complex management of pelvic fractures should allow early functional and anatomical recovery, prevent long-term morbidity and other complications.