Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2010
Pelvic Fracture and Risk Factors for Mortality: A Population-Based Study in Taiwan.
To study the incidence, demographics, distribution of fracture sites, associated injuries, and risk factors for the outcomes of pelvic fracture on a population basis. ⋯ The incidence rate of pelvic fracture was higher in females over 44 years of age, but the average medical resource use was higher in males. Associated injuries were stronger positive factors for the risk of mortality than gender, fracture sites, injury mechanisms, and the characteristics of the treating hospitals.
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Injury to the cervical spine due to a scarfassociated accident has not been reported in the literature. We present a case of a hangman's fracture in a 43-year-old woman that resulted from a scarfrelated injury as a consequence of a motor vehicle accident. ⋯ A scarf-related injury can cause an injury that resembles judicial hanging, leading to a traumatic spondylolisthesis of the axis. Careful evaluation of the cervical spine radiographs is crucial as occult fracture of the axis can be missed.
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Pelvic ring fractures represent a negative prognostic factor for what concerns morbidity and mortality of a polytraumatized patient. The subjective and functional prognosis of a pelvic ring fracture is dependent upon its degree of instability. Associated severe peripelvic soft tissue injuries and neurovascular lesions (complex pelvic trauma) affect outcome negatively. ⋯ Sequelae of neurologic lesions and genitorurinary injuries are typically associated with considerable rates of persistent functional impairment. Chronic pain and disability are often very difficult to treat. Health-related quality of life and life satisfaction after pelvic ring fractures caused by high-energy trauma is substantially lower when compared to a reference population.
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Eur J Trauma Emerg S · Apr 2010
Today's Role of External Fixation in Unstable and Complex Pelvic Fractures.
The treatment of pelvic fractures has undergone a change over the past few years. As there seems to be a trend away from external towards internal fixation, the goal of this study was to investigate whether the use of an external fixator is still a standard procedure for the initial as well as - if necessary - for the definitive treatment of complex and unstable pelvic injuries. ⋯ The use of the external fixator for the initial and in some cases for the definitive fixation of unstable and complex pelvic injuries with hemodynamic instability is still a successful treatment of multiply injured patients.
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Pelvic ring injuries form part of the spectrum of polytraumaandmust be considered a potentially lethal injury with mortality rates of 10-20%. The stabilization of the unstable pelvic ring in acute resuscitation of multiply injured patients is now conventional wisdom. We aimed: (1) to design a new iliosacral (IS) screw, (2) to prove the clinical advantages of this new implant, and (3) to work out the optimal surgical strategy using this implant. ⋯ During thelast eleven years, 244 patientswith Tile B3 and Cpelvic injuries have been stabilized with 10-mm diameter cannulated IS screws percutaneously posteriorly. Fortyeight hemodynamically unstable patientswere stabilized in the first 2 h with iliosacral screw fixation. The percutaneous pelvic ring stabilization with 10-mm cannulated screws provedstrongenoughin bothersome casesaswell.