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Rommens PM, Hofmann A, Hessmann MH. Management of Acute Hemorrhage in Pelvic Trauma: An Overview. Eur J Trauma Emerg Surg. 2010;36(2):91-9doi: 10.1007/s00068-010-1061-x.
Rommens, P. M., Hofmann, A., & Hessmann, M. H. (2010). Management of Acute Hemorrhage in Pelvic Trauma: An Overview. European journal of trauma and emergency surgery : official publication of the European Trauma Society, 36(2), 91-9. https://doi.org/10.1007/s00068-010-1061-x
Rommens, Pol M, et al. "Management of Acute Hemorrhage in Pelvic Trauma: An Overview." European journal of trauma and emergency surgery : official publication of the European Trauma Society vol. 36,2 (2010): 91-9. doi: https://doi.org/10.1007/s00068-010-1061-x
Rommens PM, Hofmann A, Hessmann MH. Management of Acute Hemorrhage in Pelvic Trauma: An Overview. Eur J Trauma Emerg Surg. 2010 Apr;36(2):91-9. doi: 10.1007/s00068-010-1061-x. Epub 2010 Mar 31. PMID: 26815682.
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Eur J Trauma Emerg Surg. 2010 Apr;36(2):91-9. doi: 10.1007/s00068-010-1061-x. Epub 2010 Mar 31.

Management of Acute Hemorrhage in Pelvic Trauma: An Overview.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

Pol M Rommens, Alexander Hofmann, Martin H Hessmann

Affiliations

  1. Center for Musculoskeletal Surgery, University Medical Center,Johannes Gutenberg-University, Mainz, Germany. [email protected].
  2. Center for Musculoskeletal Surgery, University Medical Center, Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany. [email protected].
  3. Center for Musculoskeletal Surgery, University Medical Center,Johannes Gutenberg-University, Mainz, Germany.
  4. Department of Orthopedic and Trauma Surgery, Academic Hospital Fulda, Fulda, Germany.

PMID: 26815682 DOI: 10.1007/s00068-010-1061-x

Abstract

Pelvic disruption is a combination of fractures or dislocations of the pelvic ring with trauma of the soft tissues on the inside and outside of this ring. Hemodynamic instability is the result of blood loss out of the fracture fragments, the posterior venous plexus, ruptured pelvic organs, or arterial lesions. In the resuscitation phase, different measures are possible to reduce the volume of the disrupted pelvis and to restore mechanical stability. They are not competitive but complementary. Pelvic binders should be used in the prehospital phase before and during transport. Application of a pelvic C-clamp is restricted to inhospital patients with C-type pelvic ring lesions and with severe and ongoing hemodynamic instability. External fixation is most useful in B-type but also has limited value in C-type injuries. The prerequisite for pelvic packing is the restoration of mechanical stability by pelvic C-clamping or external fixation. It is effective in severe venous bleeding in the small pelvis. Pelvic angiography and selective embolization is performed in patients with active arterial bleeding. These patients can be identified by a convincing clinical picture, by early multislice computed tomography (CT) with contrast- enhanced angiographic technique, or by the persistent need for volume replacement after C-clamping, external fixation, or pelvic packing.

Keywords: Hemorrhagic shock; Management of acute hemorrhage in pelvic trauma; Management of skeletal injuries in polytrauma; Multiple trauma; Pelvic fractures; Pelvic hemorrhage; Pelvis

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