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Dr. Jordi Teixidor Unitat de Trauma – Hospital Vall d’Hebron

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Hak DG, Smith WR, Suzuki T.Management of the Hemorrhage in Life-Threatening Pelvic Fractures.JAm Acad Orthop Surg 2009;17:447-457.

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

3

1 2

4

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

Fx Pelvis Subtipus APC i

VS

Tributària Cinturó No

Es pot fer TAC?

FixEx*

Angiografia

TAC

FixEx* +

Packing

Estable HMDE No

Sangrat actiu?

No

No

Si No

Si

Si

Si

Si

No

Estable HMDE

FixEx* +

Packing+

SI

FixEx*

Causes Abd?

Si FixEx*+

Laparo

FixEx* Estable HMDE Si UCI

No

Packing//

Angio//SI

Maneig Actual del Traumatisme Pèlvic

Maneig Actual del Traumatisme Pèlvic

• Surgeon variability in the treatment of pelvic ring injuries.

Furey AJ, O'Toole RV, Nascone JW, Copeland CE, Turen C, Sciadini MF. Orthopedics. 2010 Oct 11;33(10)

• . Classification of pelvic fractures: analysis of inter- and intraobserver variability using the Young-Burgess and Tile classification systems.

Furey AJ, O'Toole RV, Nascone JW, Sciadini MF, Copeland CE, Turen C. Orthopedics. 2009 Jun;32(6):401

• Interobserver reliability of the young-burgess and tile classification systems for fractures of the pelvic ring.

Koo H, Leveridge M, Thompson C, Zdero R, Bhandari M, Kreder HJ, Stephen D, McKee MD, Schemitsch EH.

Division of Orthopaedic Surgery; and daggerMartin Orthopaedic Biomechanics Lab, St. Michael's Hospital, Toronto, Ontario, Canada. J Orthop Trauma. 2008 Jul;22(6):379-84

• Fracture of the pelvis: current concepts of classification.Young JW, Resnik CS.Department of Radiology, University of Maryland Medical System/Hospital, Baltimore 21201. AJR Am J Roentgenol. 1990 Dec;155(6):1169-75.

• Do initial radiographs agree with crash site mechanism of injury in pelvic ring disruptions? A pilot study.

Linnau KF, Blackmore CC, Kaufman R, Nguyen TN, Routt ML Jr, Stambaugh LE 3rd, Jurkovich GJ, Mock CN.Department of Radiology, Harborview Medical Center, Seattle, Washington 98104-2499, USA. J Orthop Trauma. 2007 Jul;21(6):375-80.

Maneig Actual del Traumatisme Pèlvic

• How (un)useful is the pelvic ring stability examination in diagnosing mechanically unstable pelvic fractures in blunt trauma patients? Shlamovitz GZ, Mower WR, Bergman J, Chuang KR, Crisp J, Hardy D, Sargent M, Shroff SD, Snyder E, Morgan MT. Department of Emergency Medicine and Traumatology, Hartford Hospital, UCONN School of Medicine, University of Connecticut, Hartford, Connecticut, USA. J Trauma. 2009 Mar;66(3):815-20

• What constitutes a Young and Burgess lateral compression-I (OTA 61-B2) pelvic ring disruption? A description of computed tomography-based fracture anatomy and associated injuries. Lefaivre KA, Padalecki JR, Starr AJ. Department of Orthopaedics Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA. J Orthop Trauma. 2009 Jan;23(1):16-21.

• Predicting blood loss in isolated pelvic and acetabular high-energy trauma. Magnussen RA, Tressler MA, Obremskey WT, Kregor PJ. Division of Orthopaedic Trauma, Vanderbilt Orthopaedic Institute, Nashville, Tennessee 37232-8774, USA. Orthop Trauma. 2007 Oct;21(9):603-7

• Pelvic disruption: assessment and classification. Pennal GF, Tile M, Waddell JP, Garside H. Clin Orthop Relat Res. 1980 Sep;(151):12-21

• Pelvic fractures: value of plain radiography in early assessment and management. Young JW, Burgess AR, Brumback RJ, Poka A. Radiology. 1986 Aug;160(2):445-51

• Pelvic ring disruptions: effective classification system and treatment protocols.

Burgess AR, Eastridge BJ, Young JW, Ellison TS, Ellison PS Jr, Poka A, Bathon GH, Brumback RJ.

Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore J Trauma. 1990 Jul;30(7):848-56

Maneig Actual del Traumatisme Pèlvic