Die komplexe Beckenverletzung im Kindesalter

H Schmal, C Klemt, C Haag, F Bonnaire

Publikation: Bidrag til tidsskriftTidsskriftartikelFormidling

Resumé

Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

OriginalsprogTysk
TidsskriftDer Unfallchirurg
Vol/bind105
Udgave nummer8
Sider (fra-til)748-54
Antal sider7
ISSN0177-5537
StatusUdgivet - aug. 2002

Fingeraftryk

Wounds and Injuries
Soft Tissue Injuries
Hemorrhagic Shock
Multiple Trauma
Consultants
Skeleton
Cause of Death
Quality of Life

Emneord

  • Child
  • Child, Preschool
  • External Fixators
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal
  • Fracture Healing
  • Hemoperitoneum
  • Humans
  • Iliac Artery
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Male
  • Multiple Trauma
  • Pelvic Bones
  • Reoperation
  • Tomography, X-Ray Computed

Citer dette

Schmal, H., Klemt, C., Haag, C., & Bonnaire, F. (2002). Die komplexe Beckenverletzung im Kindesalter. Der Unfallchirurg, 105(8), 748-54.
Schmal, H ; Klemt, C ; Haag, C ; Bonnaire, F. / Die komplexe Beckenverletzung im Kindesalter. I: Der Unfallchirurg. 2002 ; Bind 105, Nr. 8. s. 748-54.
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Schmal, H, Klemt, C, Haag, C & Bonnaire, F 2002, 'Die komplexe Beckenverletzung im Kindesalter', Der Unfallchirurg, bind 105, nr. 8, s. 748-54.

Die komplexe Beckenverletzung im Kindesalter. / Schmal, H; Klemt, C; Haag, C; Bonnaire, F.

I: Der Unfallchirurg, Bind 105, Nr. 8, 08.2002, s. 748-54.

Publikation: Bidrag til tidsskriftTidsskriftartikelFormidling

TY - JOUR

T1 - Die komplexe Beckenverletzung im Kindesalter

AU - Schmal, H

AU - Klemt, C

AU - Haag, C

AU - Bonnaire, F

PY - 2002/8

Y1 - 2002/8

N2 - Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

AB - Pelvic disruptions are rare in children caused by the flexible anchoring of bony parts associated with a high elasticity of the skeleton. Portion of pelvic fractures in infants is lower than 5% even when reviewing cases of specialized centers. The part of complex pelvic injuries and multiple injured patients in infants is higher when compared to adults, a fact caused by the more intense forces that are necessary to lead to pelvic disruption in children. Combination of a rare injury and the capability of children to compensate blood loss for a long time may implicate a wrong security and prolong diagnostic and therapeutic procedures--a problem that definitely should be avoided. Three cases were analyzed and established algorithms for treatment of patients matching these special injury-features demonstrated. A good outcome may only be achieved when all components of injury pattern get recognized and treatment is organized following the hierarchy of necessity. Therefore in the time table first life-saving steps have to be taken and then accompanying injuries can be treated that often decisively influence life quality. As seen in our cases unstable and dislocated fractures require open reduction and internal fixation ensuring nerval decompression, stop of hemorrhage and realizing the prerequisite for effective treatment of soft tissue damage. The acute hemorrhagic shock is one of the leading causes of death following severe pelvic injuries. After stabilization of fracture, surgical treatment of soft tissue injuries and intraabdominal bleeding sources the immediate diagnostic angiography possibly in combination with a therapeutic selective embolization is a well established part of the treatment. The aim of complete restitution can only be accomplished by cooperation of several different specialists and consultants in a trauma center.

KW - Child

KW - Child, Preschool

KW - External Fixators

KW - Female

KW - Follow-Up Studies

KW - Fracture Fixation, Internal

KW - Fracture Healing

KW - Hemoperitoneum

KW - Humans

KW - Iliac Artery

KW - Image Processing, Computer-Assisted

KW - Imaging, Three-Dimensional

KW - Male

KW - Multiple Trauma

KW - Pelvic Bones

KW - Reoperation

KW - Tomography, X-Ray Computed

KW - Case Reports

KW - Journal Article

M3 - Tidsskriftartikel

VL - 105

SP - 748

EP - 754

JO - Der Unfallchirurg

JF - Der Unfallchirurg

SN - 0177-5537

IS - 8

ER -

Schmal H, Klemt C, Haag C, Bonnaire F. Die komplexe Beckenverletzung im Kindesalter. Der Unfallchirurg. 2002 aug;105(8):748-54.