scholarly journals Pelvis fracture: up to date

2019 ◽  
pp. 19-29 ◽  
Author(s):  
Marta García-Chamorro
Keyword(s):  
Emergency Department ◽  
Pelvic Fractures ◽  
Orthopaedic Surgeons ◽  
Pelvis Fracture

Pelvic fractures are very frequent in the emergency department. Its diagnosis and its treatment sometimes can be difficult, specially in the junior orthopaedic surgeons. This up to date has the aim of making easier to understand how do the behave and how to treat them

scholarly journals The use of external fixation in the emergency department: applications, common errors, complications and their treatment

2020 ◽  
Vol 5 (4) ◽  
pp. 204-214 ◽  
Author(s):  
Carlos A. Encinas-Ullán ◽  
José M. Martínez-Diez ◽  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Magnetic Resonance Imaging ◽  
Emergency Department ◽  
External Fixation ◽  
Pelvic Fractures ◽  
Resonance Imaging ◽  
Life Saving ◽  
Magnetic Resonance Imaging Mri ◽  
Free Placement ◽  
Pelvic Lesions ◽  
Anterior Posterior

The use of an external fixator (EF) in the emergency department (ED) or the emergency theatre in the ED is reserved for critically ill patients in a life-saving attempt. Hence, usually only fixation/stabilization of the pelvis, tibia, femur and humerus are performed. All other external fixation methods are not indicated in an ED and thus should be performed in the operating room with a sterile environment. Anterior EF is used in unstable pelvic lesions due to anterior-posterior compression, and in stable pelvic fractures in haemodynamically unstable patients. Patients with multiple trauma should be stabilized quickly with EF. The C-clamp has been designed to be used in the ED to stabilize fractures of the sacrum or alterations of the sacroiliac joint in patients with circulatory instability. Choose a modular EF that allows for the free placement of the pins, is radiolucent and is compatible with magnetic resonance imaging (MRI). Planning the type of framework to be used is crucial. Avoid mistakes in the placement of EF. Cite this article: EFORT Open Rev 2020;5:204-214. DOI: 10.1302/2058-5241.5.190029

Pre-hospital and emergency department management of pelvic fractures and major trauma centre status: Has practice changed?

Trauma ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 207-211
Author(s):  
Jonathan Barnes ◽  
Philip Thomas ◽  
Ramsay Refaie ◽  
Andrew Gray
Keyword(s):  
Emergency Department ◽  
Clinical Practice ◽  
Pelvic Fracture ◽  
Major Trauma ◽  
High Energy ◽  
Trauma Centre ◽  
Pelvic Fractures ◽  
Major Trauma Centre ◽  
Initial Imaging ◽  
One Year

Introduction Pelvic fractures are indicative of high-energy injuries and carry a significant morbidity and mortality and pelvic binders are used to stabilise them in both the pre-hospital and emergency department setting. Our unit gained major trauma centre status in April 2012 as part of a national programme to centralise trauma care and improve outcomes. This study investigated whether major trauma centre status led to a change in workload and clinical practice at our centre. Methods A retrospective analysis of all patients admitted with a pelvic fracture for the six-month periods before, after and at one-year following major trauma centre status designation. Data were retrospectively collected from electronic patient records and binder placement assessed using an accepted method. Patients with isolated pubic rami fractures were excluded. Results Overall, 6/16 (37.5%) pelvic fracture admissions had a binder placed pre-major trauma centre status, rising to 14/34 (41.2%) immediately post-major trauma centre status and 22/32 (68.8%) ( p = 0.025) one year later. Binders were positioned accurately in 4 patients (80%, one exclusion) pre-major trauma centre status, 12 (92.4%) post-major trauma centre status and 22 (100%) at one year. CT imaging was the initial imaging used in 9 (56.3%) patients pre-major trauma centre status, 29 (85.3%) ( p = 0.04) post-major trauma centre status and 27 (84.4%) at one year. Discussion Pelvic fracture admissions doubled following major trauma centre status. Computed tomography, as the initial imaging modality, increased significantly with major trauma centre status, likely a reflection of the increased resources made available with this change. Although binder application rates did not change immediately, a significant improvement was seen after one year, with binder accuracy increasing to 100%. This suggests that although changes in clinical practice often do not occur immediately, with the increased infrastructure and clinical exposure afforded through centralisation of trauma services, they will occur, ultimately leading to improvements in trauma patient care.

Utility of Plain Film Pelvic Radiographs in Blunt Trauma Patients in the Emergency Department

2006 ◽  
Vol 72 (10) ◽  
pp. 951-954 ◽  
Author(s):  
Amal Kamil Obaid ◽  
Andrew Barleben ◽  
Diana Porral ◽  
Stephanie Lush ◽  
Marianne Cinat
Keyword(s):  
Emergency Department ◽  
Ct Scan ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Plain Film ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Pelvic Radiographs ◽  
Highly Sensitive ◽  
Pelvic Embolization

The objective of this study was to evaluate the utility and sensitivity of routine pelvic radiographs (PXR) in the initial evaluation of blunt trauma patients. A retrospective review was performed. One hundred seventy-four patients with a pelvic fracture who had computed tomography (CT) and PXR were included (average age, 36.1; average Injury Severity Score, 16.3). Nine (5%) patients died. Five hundred twenty-one fractures were identified on CT. One hundred sixteen (22%) of these fractures were missed by PXR. Eighty-eight (51%) patients were underdiagnosed by PXR alone. The most common fractures missed by PXR were sacral and iliac fractures. Eight patients required angiograms, with four undergoing therapeutic pelvic embolization. Forty-seven (27%) patients were hypotensive or required a transfusion in the emergency department. These patients were more likely to require an angiogram (17% vs 0%, P < 0.0001) and were more likely to require embolization (9% vs 0%, P < 0.001). This study demonstrates that CT scan is highly sensitive in identifying and classifying pelvic fractures. PXR has a sensitivity of only 78 per cent for identification of pelvic fractures in the acute trauma patient. In hemodynamically stable patients who are going to undergo diagnostic CT scan, PXR is of little value. The greatest use of PXR may be as a screening tool in hemodynamically unstable patients and/or those that require transfusion to allow for early notification of the interventional radiology team.

Radiographic Detection of Hip and Pelvic Fractures in the Emergency Department

2010 ◽  
Vol 194 (4) ◽  
pp. 1054-1060 ◽  
Author(s):  
Matthew W. Kirby ◽  
Charles Spritzer
Keyword(s):  
Emergency Department ◽  
Pelvic Fractures
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