Case reportSelective faecal diversion in open pelvic fractures: Reassessment based on recent experience
Section snippets
Case reports
Case 1: A 53-year-old male had a motorcycle accident on a rural road. At the scene, the patient was hypotensive, tachycardic and actively bleeding from his left flank. On arrival in the emergency department (ED), he had an obvious open pelvic fracture through the left iliac wing. The pelvic X-ray confirmed an open book (Tile B1 type) fracture with an open, comminuted iliac wing fracture on the left side. The wound was located at the left iliac wing with a length of 10 cm and width of 6 cm,
Discussion
Open pelvic fractures are still consistent with high morbidity and mortality. Protocols based on either early angiography and embolisation or pelvic packing and early stabilisation of the fracture have reduced the mortality in the past two decades.15, 16 In addition to these protocols, the immediate packing of the open wound and consideration of faecal diversion in open pelvic fractures have become principles of management.
In 1997, Jones and colleagues showed a 25% mortality rate following open
Conflict of interest
All authors declare that they did not receive any outside funding or grants in support of our research or preparation of the manuscript.
References (19)
- et al.
Open pelvic fractures: an injury for trauma centres
Am J Surg
(1992) - et al.
Compound fractures of the pelvis
Am J Surg
(1976) - et al.
Open pelvic fractures: epidemiology, current concepts of management and outcome
Injury
(2005) - et al.
Open pelvic fractures a multi-center retrospective analysis
Ortho Clin North Am
(1997) - et al.
Pelvic fractures associated with open perineal wounds: a survivable injury
J Trauma
(1993) - et al.
Open fractures of the pelvis
J Bone Joint Surg [Br]
(1991) - et al.
The deep perineal laceration – an injury frequently associated with open pelvic fractures: a need for aggressive surgical management. A report of 12 cases and review of the literature
J Trauma
(1977) - et al.
Open pelvic fractures
J Trauma
(1982) - et al.
The outcome of open pelvic fractures in the modern era
Am J Surg
(2005)
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