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Prise en charge des fractures du bassin associées a une plaie périnéale

Published in Swiss surgery. 1999, vol. 5, no. 1, p. 33-7
Abstract Unstable fractures of the pelvic ring, associated to perineal lacerations are severe injuries occurring during high-energy trauma. High rates of septic complications and mortality have been reported with these injuries. Current treatment guidelines, while dealing with open pelvic fractures or dislocations are discussed, based on a current review of the literature and on our local experience. At our institution, 55 unstable type B or C fractures of the pelvic ring were treated by osteosynthesis between 1991 and 1997. Of these, 11 patients presented with an associated perineal laceration (20%). Simultaneously to the immediate pelvic ring fixation, a diversion colostomy was performed in all these patients. Repeated wound debridements and wide spectrum antibioprophylaxis were associated. Of these 11 patients presenting an open pelvic fracture, only one died of pelvic sepsis at three weeks. 10 patients survived (91%) and went on to bony union, without any local infectious complications. Aggressive multidisciplinary initial surgical management is a rule when dealing with this type of injuries, immediate colostomy and careful wound debridement must be associated to the initial osteosynthesis.
Keywords AdultFemaleFractures, Open/surgeryHumansMalePelvic Bones/injuries/surgeryPerineum/injuries/surgery
PMID: 10073130
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Article (Published version) (3.3 MB) - document accessible for UNIGE members only Limited access to UNIGE
Research groups Chirurgie orthopédique et traumatologique (98)
Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Groupe Bruno Roche (chirurgie colo-rectale) (92)
(ISO format)
MICHEL, Jean-Marie Walter André et al. Prise en charge des fractures du bassin associées a une plaie périnéale. In: Swiss surgery, 1999, vol. 5, n° 1, p. 33-7. https://archive-ouverte.unige.ch/unige:72976

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Deposited on : 2015-06-03

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