Problems of improving the results of surgical treatment of the pelvic injuries
Among all fractures, pelvic injuries are 5–8 %, and combined trauma — 30–58 %. The level of mortality due to unstable pelvic fractures ranges from 10 to 18 %, and in patients with polytrauma — 36.5–50 %.
Objective: to analyze the organizational problems of treating patients with pelvic injuries in Ukrainian clinics and to propose ways of their solutions.
Methods: a retrospective study of surgical treatment results of patients with pelvic fractures was made. Patients of group 1 osteosynthesis of pelvic bone fractures were carried out in the traumatological departments of the Kyiv City Clinical Hospital of Emergency Care in 1991–2007 and the Orthopaedic and Traumatology Center of the Kyiv Regional Clinical Hospital (KRCH) in 2002–2009, group 2 in KRCH 2010–2017. The differences between tactical and surgical approaches were studied, results were obtained. For the analysis a system of functional characteristics of the pelvic fractures of Majeed was used.
Results: consequences of surgical treatment in group 1 were studied in 119 patients (58.3 %) with unstable pelvic injuries in 12 months and later after trauma. An excellent result was registered in 11 patients (9.2 %), good in 48 (40.3 %), satisfactory — 51 (42.9 %), unsatisfactory — 9 (7.6 %). In group 2, the results of treatment were evaluated in 114 (61.2 %) patients: excellent result was in 21 (18.4 %), good in 55 (48.2 %), satisfactory — 31 (27.2 %), unsatisfactory — 7 (6.2 %).
Conclusions: due to mastering the methods of osteosynthesis of pelvic fractures at special courses and introducing them into practice, due to correspondent equipment of the department and operation room the amount of complications was decreased to 11.1 %, unsatisfactory — to 1.4 %, and a percentage of good and excellent results was increased to 17.1 %.
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