• Journal of Trauma and Injury
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• 제20권1호
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• pp.26-32
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• 2007

Purpose: Hemorrhagic shock is the leading cause of death in patients with pelvic bone fractures. The majority of blood loss is due to injured pelvic arteries and retroperitoneal veins and to bleeding from the fracture site itself. Pelvic angiography and embolization of injured vessels is an effective way to control continuous bleeding. However, identifying the bleeding focus in hemodynamically unstable patients before diagnostic intervention is difficult. The purpose of this study was to determine the correlation between fracture patterns in hemodynamically unstable patients with pelvic fractures and later pelvic angiography findings. Methods: We performed a retrospective study of 21 hemodynamically unstable patients with pelvic fractures admitted to our emergency department between April 2001 to April 2006. All 21 patients underwent pelvic angiography. Pelvic fractures were assessed according to the Tile's classification and the degree of injury was assessed using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). The hemodynamic status of the patients was defined using vital signs, base excess, and blood lactate. Fracture patterns were compared with hemodynamic status and angiography findings. Results: In the 5year study period, 21 hemodynamically unstable pelvic bone fracture patients were admitted; ten were men (47.6%), and 11 were women (52.4%). The mean age was 41.1 years (range: ${\pm}20.1$). Of the 21 embolization was performed in 6 patient (28.6%): 1 patient of the 5 unstable pelvic bone fracture patients (20%), and 5 patients of 16 the stable pelvic bone fracture patients (31.3%). There were no significant differences between the RTS (p=0.587) and embolization rate (p=0.774) for either the stable patients or the unstable patients. Patients with arterial injury on angiography had a lower RTS compared with patients without arterial injury but there was no significant difference in ISS between the two groups. The angiographic injured sites were five internal femoral arteries and one external femoral artery. Conclusion: The findings in this study suggest that the pelvic fracture pattern in hemodynamically unstable patients with pelvic fractures does not correlate with pelvic angiography findings.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.6-12
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• 2024

Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.

• 대한의료기공학회지
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• 제13권1호
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• pp.1-18
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• 2013

Objective : The objective of this study is to report the effectiveness of conservative treatment on simple pelvic fracture with ostomy. Methods : A female patient 65 years old with ostomy, who were diagnosed as simple pelvic fracture by X-ray, were treated with conservative treatment by herbal medication with acupuncture and physical therapy. We evaluated the effectiveness by checking X-ray, Digital Infrared Thermal Imaging(D.I.T.I.). Results : The symptoms of the patient got improved and X-ray showed the fracture were healing. Conclusions : Conservative korean medical treatment can be effectively used for a patient with simple pelvic fracture and ostomy.

• 대한한방부인과학회지
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• 제28권4호
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• pp.88-96
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• 2015

Objectives : This study is to report the effectiveness of Korean medical treatment in case of pubic fracture with pelvic pain. Methods : Pubic fracture patient with pelvic pain was treated by Gamigunggwui-tang and acupuncture. This study was evaluated by VAS (visual analogue scale) and radiography. Results : After treatment, VAS of pain decreased and radiography image showed that fracture is healing. Conclusions : We could prove Korean medical treatment is effective for recovery of pubic fracture and pelvic pain.

• 한방재활의학과학회지
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• 제28권2호
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• pp.135-148
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• 2018

The objective of this study is to investigate conservative treatment of pelvic fracture, and report that Korean rehabilitation treatment is effective for pelvic fracture. We reported a case about pelvic fracture treated with Korean rehabilitation treatment. We searched 10 domestic electronic databases to find reports on conservative treatment of pelvic fracture. We selected and analyzed 12 studies. In this case, pain, range of motion, and Oswestry Disability Index of patient were improved by Korean rehabilitation treatment. In analysis, traction, pelvic sling, hip spica cast, pelvic belt, medication are used in western medical treatment. Acupuncture, herbal medicine, cupping, moxibustion, physical therapy, manual therapy are used in Korean medical treatment. Most of conservative treatments are effective for pain, bone union, osteoporosis, dysfunction. In this study, we expect further study of Korean rehabilitation treatment program for pelvic fracture to compensate existing conservative treatment.

• Journal of Korean Neurosurgical Society
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• 제38권1호
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• pp.77-79
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• 2005

We report a case of early stress fracture of the pelvic ring following an extension of a multilevel instrumented lumbosacral fusion in an osteopenic female. Surgeons should be aware of possibilities of pelvic complications in osteopenic patients with lumbosacral arthrodesis and should take care when harvesting iliac bone graft.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.272-275
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• 2015

Pelvic bone fracture with unstable vital signs is a life-threatening condition demanding proper diagnosis and immediate treatment. Unlike long bones, the pelvic bone is a three dimensional structure with complex holes and grooves for vessels and nerves. Because of this complexity, a pelvic bone fracture can lead to complicated and serious bleeding. We report a case of a fifty-year-old male suffering from a pelvic bone fracture due to a fall. An imaging study showed fractures of both the superior and the inferior ramus of the pubic bone, with contrast extravasation underneath them, resulting in a large preperitoneal hematoma. He was sent for angiography, which revealed a hemorrhage from a branch of the left obturator artery. Embolization was done with a glue and lipiodol mixture. The patient recovered without complication, and was discharged at four weeks after admission.

• Journal of Trauma and Injury
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• 제27권2호
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• pp.29-32
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• 2014

Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

• 한국임상수의학회지
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• 제28권5호
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• pp.467-472
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• 2011

본 연구의 목적은 골반 골절을 지닌 54두의 환축의 임상적 결과를 분석하고 체중 지지까지의 기간, 입원 기 간, 수술 후 파행 등급 등을 평가하는데 있다. 54두의 환축에서 총 195 부위의 골절을 확인하였으며, 이중 47두에서는 2 부위 이상 골절이 확인되었다. 수술을 실시한 31마리에서 수술 이후 체중 지지까지 걸린 평균 기간은 7.04일이었으며, 평균 입원 기간은 16.39일이었다. 또한 수술 이후 평균 최종 파행 등급은 1.25 이었다. 천장골 탈구, 장골 골절, 관 골구 골절 간의 체중 지지 기간, 입원 기간, 최종 파행 등급에서 유의적 차이는 없었다. 수술을 2 부위 이상 실시한 경우와 양측 골반을 동시에 수술한 경우에서 입원 기간과 최종 파행 등급은 유의적인 증가를 보였다. 결론적으로 골 절의 위치보다 골절의 개수가 골절의 회복에 더 큰 영향을 주는 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.234-237
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• 2005

The neuropathic pain caused by lumbosacral plexopathy as a sequela to extensive pelvic and sacral fractures is rare because many posttraumatic cases remain undiagnosed as a result of the high mortality associated with these types of injury and because of the survivors of multiple trauma, including pelvic fractures, frequently have an incomplete work-up. Although surgical treatments for medically refractory lumbosacral plexus avulsion pain have been reported, an effective surgical technique for pain relief in lumbosacral plexopathy has not been well documented. We describe the effectiveness of spinal cord stimulation [SCS] in a patient suffering from severe neuropathic pain caused by lumbosacral plexopathy after an extensive pelvic fracture.