OTA-AAST Pelvic Fx Symposium 2000

Pelvic Injury References

Anatomy

• NLM Axial Visible Human Data - soft tissue & bone
• NLM 3D Visible Human Data - bone
• Pelvic Anatomy
• Postmortem pelvic fracture vascular pathoanatomy

Mechanism of Injury & Classification

• Tile & Young-Burgess Classifications
• Combined Mechanical Injury

Morbidity and Mortality

• Morbidity and mortality related to injury mechanism and fracture pattern
• Pelvic fracture classification and associated injury
• Associated aortic rupture with pelvic fracture
• Mortality in retroperitoneal hematoma.

Hemoperitoneum - FAST/DPL - Laparotomy

• Abdominal Ultrasonography - Review
• An algorithm to reduce the incidence of false-negative FAST examinations in patients at high risk for occult injury.
• Abdominal injuries without hemoperitoneum: a potential limitation of focused abdominal sonography for trauma
• DPL False Positives
• Pelvic Packing Techniques of Ertel and Pohlemann

Angio

• Correlation of fracture pattern with angiographic findings.
• Correlation of fracture pattern with angiographic findings.
• Predicting a need for angiography with pelvic fracture.
• A protocol for the initial management of unstable pelvic fractures - prospective study.
• Retrospective review of early embolization.
• Bladder necrosis secondary to pelvic artery embolization: case report and literature review.
• Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage
• Current management of pelvic fractures: a combined surgical-angiographic approach to hemorrhage.

Ex Fix

• A protocol for the initial management of unstable pelvic fractures - prospective study.
• Acute mortality associated with injuries to the pelvic ring: efficacy of external fixation.
• The effect of laparotomy and external fixator stabilization on pelvic volume in an unstable pelvic injury.
• Volume changes within the true pelvis during disruption of the pelvic ring--where does the haemorrhage go?
• Pressure-volume characteristics of the intact and disrupted pelvic retroperitoneum.
• External fixator vs. pelvic clamp devices.
• External fixation and posterior pelvic deformity
• Errors with pin placement

ORIF

• Early open reduction and internal fixation of the disrupted pelvic ring.
• Symphysis pubis internal fixation.
• Designs of symphysis pubis internal fixation.

Iliosacral Screws

• Vertical shear injury and percutaneous ilio-sacral screws.
• Resuscitation and early definitive stabilization.
• Proximity to neurovascular structures after internal fixation.
• Iliosacral Screws & Closed Pelvic Reduction
• Iliosacral Screws & Operating Times

Abdominal Compartment Syndrome

• Management of the difficult abdominal closure.
• Secondary abdominal compartment syndrome: an underappreciated manifestation of severe hemorrhagic shock.
• Bilateral ureteral obstruction and renal failure caused by massive retroperitoneal hematoma: is there a pelvic compartment syndrome analogous to abdominal compartment syndrome?
• Abdominal compartment syndrome.
• Abdominal compartment syndrome.
• Prospective characterization and selective management of the abdominal compartment syndrome.

Non-Invasive Pelvic Stabilization

• G-Suit for definitive control of bleeding from severe pelvic fractures.
• Provisional pelvic stabilization (Dallas binder, G-Suit, Kendrick extrication device, Geneva belt, London splint)