CLINICAL FEATURES OF AND INITIAL MANAGEMENT STRATEGIES FOR OPEN PELVIC FRACTURES : A REVIEW OF SEVEN PATIENTS IN A TRAUMA CENTER IN TOKYO

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  • NAGAO Tsuyoshi
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Resuscitation Center
  • TSUNOYAMA Taichiro
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Resuscitation Center
  • SUZUKI Takashi
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Reconstruction Center
  • ITO Kaori
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Resuscitation Center
  • ISHII Keisuke
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Reconstruction Center
  • KUROZUMI Taketo
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Reconstruction Center
  • FUJITA Takashi
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Resuscitation Center
  • MIYAKE Yasufumi
    Teikyo University School of Medicine, Department of Emergency Medicine Teikyo University Hospital, Trauma and Resuscitation Center
  • SAKAMOTO Tetsuya
    Teikyo University School of Medicine, Department of Emergency Medicine
  • MORIMURA Naoto
    Teikyo University School of Medicine, Department of Emergency Medicine

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Other Title
  • 骨盤開放骨折の臨床的特徴と急性期治療戦略の検討

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Abstract

<p>　　Purpose : To investigate open pelvic fracture cases and characterize their clinical picture and initial management strategies. Methods : This single-center retrospective study involved seven patients with open pelvic fractures treated at our hospital between 2015 and 2019. Results : All seven patients had unstable pelvic fractures and a median abbreviated injury scale [AIS, version 90-98] of 5 [interquartile range, 4.5-5] , with open wounds in Zone 1 of the Faringer classification, and classified as Class 3 of the Jones-Powell classification. Six patients required massive transfusion, all seven patients underwent transcatheter arterial embolization and fixation with a pelvic binder, three received gauze packing of an open wound, and six underwent external pelvic fixation. All patients had a colostomy ; this procedure was performed urgently in four patients with and three without anorectal injury, but there was a risk of wound contamination. There were two in-hospital mortalities : one from sepsis due to deep infection in an open wound, and one due to multiple organ failure. There were no deaths due to acute hemorrhage. Conclusion : In cases of open pelvic fractures, prompt hemostasis and infection control with timely colostomy are important.</p>

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