Management of pelvic area trauma

master's thesis

• Title (croatian): Liječenje traumatske ozljede zdjelice
• Author: Hanan El Sana
• Mentor: Ivan Dobrić (mentor)
• Committee member: Ivan Dobrić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Tomislav Đapić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Among the different manifestations of trauma, complex pelvic injuries are some of the most dangerous and deadly trauma related lesions. Pelvic trauma is one of the most complex to manage in trauma care and occurs in 3% of skeletal injuries,, with associated mortality rates of 10-16%. Most pelvis injuries require a significant amount of force. The most common mechanisms of injury include motor vehicle accidents. Due to the high force associated with pelvic fractures, they are commonly associated with other injuries, require transfusions , and prolonged rehabilitation. The most common and worrisome associated injury is hemorrhage. Consequently, the management of trauma aims initially to restore the altered physiology. The main aims of proper pelvic trauma management are thus to control bleeding and stabilize the hemodynamic status. Early proper treatment can decrease the development of disabilities, preventing septic, urogenital, vascular, and sexual function complications. Once the patient with pelvic fracture is resuscitated and stabilized, definitive surgical management and anatomic restoration of the pelvic ring become the goal. Management includes stabilization with pelvic binders, preperitoneal pelvic packing, resuscitative endovascular balloon occlusion of the aorta, angiography for embolization of bleeding pelvic vessels, and operative stabilization of the pelvic fracture either internally (ORIF) or externally.

Abstract (croatian)

Među različitim manifestacijama traume, složene ozljede zdjelice su neke od najopasnijih i smrtonosnih lezija povezanih s traumom. Zdjelična trauma je jedna od najsloženijih u upravljanju traumom i javlja se u 3% skeletnih ozljeda, s pripadajućim stopama smrtnosti od 10-16%. Većina ozljeda zdjelice zahtijeva značajnu količinu sile. Najčešći mehanizmi ozljede uključuju nezgode motornih vozila. Zbog velike sile povezane s frakturama zdjelice, one su obično povezane s drugim ozljedama, zahtijevaju transfuzije i produljenu rehabilitaciju. Najčešća i zabrinjavajuća ozljeda je krvarenje. Prema tome, upravljanje traumom u svom početku ima za cilj vraćanje izmijenjene fiziologije. Glavni ciljevi pravilnog upravljanja traumom zdjelice stoga kontroliraju krvarenje i stabiliziraju hemodinamski status. Pravilan rani tretman može smanjiti razvoj invaliditeta, sprječavajući septičke, urogenitalne i vaskularne komplikacije te komplikacije seksualnih funkcija. Nakon što je pacijent s prijelomom zdjelice oživljen i stabiliziran, cilj postaju konačno kirurško upravljanje i anatomska obnova zdjelice. Upravljanje uključuje stabilizaciju s vezivima za zdjelicu, preperitonealno pakiranje zdjelice, resuscitativnu endovaskularnu balonsku okluziju aorte, angiografiju za embolizaciju krvarenja zdjelice te operativnu stabilizaciju prijeloma zdjelice, interno (ORIF) ili eksterno.

• Keywords: trauma; pelvic trauma; pelvic fracture; managment; initial evaluation; pelvic binder; PPP; stabilization; external fixation; ORIF
• Keywords (croatian): trauma; trauma zdjelice; prijelom zdjelice; upravljanje; početna procjena; vezivo za zdjelicu; PPP; stabilizacija; eksterna fiksacija; ORIF
• Language: english
• URN:NBN: urn:nbn:hr:105:405955
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-12-21 08:36:26