Multiple fractures of the pelvic bones
Traumatology / / August 12, 2017
Multiple bone fractures of the pelvis are themselves in serious injury, especially accompanied by a massive interstitial hemorrhage.When combined with other pelvic fractures damage usually are leading in the overall clinical picture injury.
Among the victims with multiple fractures, patients with fractures of the pelvis were 3.3%, including associated injuries - 25.5% of all multiple injuries - 10.8%.The causes of multiple fractures pelvis injuries were transport - 41.3%, falling from a height - 32.9%, the street - 15%, etc. The main features of
Every second victim with fractures of the pelvis develops traumatic shock.II-III often degree.Shock and deaths associated primarily with massive blood loss.The formation of extensive retroperitoneal hematoma and intermuscular typical severe pelvic fractures.Influence of retroperitoneal hematoma in the clinical picture of injuries is very high: symptoms of shock, blood loss, and a number of other signs of "acute abdomen", increasing with the
- Multiple rib fractures
- Multiple fractures of foot
- Multiple fractures wrist
- Multiple fractures of femur
- Multiple fractures of the tibia
- Multiple fractures ankle
- Multiple fracturesthe knee
- multiple fractures of the bones and the bones of one segment
- clinical picture of multiple fractures pelvis
- Combined treatment of injuries
- treatment of multiple rib fractures
damage the internal organs of the abdomen for fractures of the pelvis(colon, small intestine, liver) observed in 6.6% of patients.Diagnosis of these injuries is very difficult, especially when combined fractures of the pelvis and ribs.In these cases, the diagnosis of help dynamic observation and "double" novocaine blockade - and intercostal intrapelvic on both sides.In the absence of internal injuries after 30-40 minutes after the blockade of the abdominal wall becomes soft, preventing deep palpation.This technique helps to avoid unnecessary laparotomy.The accuracy of diagnosis significantly increases laparocentesis whose safety is ensured by the following conditions: a puncture of the abdominal wall is made trocar after pulling her skin using two ligatures, using the technique of "groping" of the catheter, in the case of "dry" puncture produce wash the abdominal cavity with isotonic sodium chloride solution, followed bystudy of the washing liquid.
The diagnostic value of the method is increased when using dynamic lavage, which is absolutely not excluding intra-abdominal catastrophe, clearly picks up the pace of its growth.Puncture of the abdominal wall can be carried out also through the stomach, lifting his taped.Of course, in all cases where using the following adaptations ensure that no intra-abdominal injury is not possible, to delay the laparotomy should not be - safer to operate than to miss a hollow gap parenchymal organ or break mesenteric vessels, intestines and diaphragm.