Fraturas do anel pélvico: estudo epidemiológico

Abstract

De fevereiro de 2000 a setembro de 2001, 84 pacientes apresentando fratura do anel pélvico foram avaliados, segundo determinado protocolo aplicado. Houve predomínio do sexo masculino (67%), a maioria dos pacientes eram brancos (86%) e a idade média foi de 37 anos. Quanto ao tipo de acidente, os mais freqüentes foram os relacionados ao trânsito (58%) - carro, moto e atropelamento - pacientes vítimas de traumas de alta energia. As fraturas foram classificadas de acordo com Tile(13) em estáveis, em 55% (fraturas do tipo A); rotacionalmente instáveis, em 30% (fraturas do tipo B) e rotacional e verticalmente instáveis, em 15% (fraturas do tipo C). A fratura mais freqüentemente encontrada foi a dos ramos isquiopúbicos. O tratamento cirúrgico foi realizado em 29% dos pacientes. Houve necessidade de transfusão sangüínea em 20% dos pacientes, utilizando-se uma média de cinco unidades de sangue total; exceto dois pacientes (2,4%) com lesão arterial intra pélvica que necessitaram mais de 10 unidades de sangue nas primeiras 48 horas. A mortalidade foi de sete por cento tendo relação significativa com traumas extra pélvicos.

Epidemiology of pelvic ring fractures and injuries

“…Moreover, in their study the order was similar to that observed in the present study: type B (rotationally unstable and vertically stable) was the second most common, followed by type C (rotationally and vertically unstable). Chueire et al 9 reported that type A injuries were the most common, occurring in 55% of the sample, and were also related to the elderly, with involvement of ischiopubic branches; in that study, the subtype A 2.2 was the most common. Those authors also observed type B (30%) as the second most common, followed by type C (15%).…”

“…In turn, elderly patients with fractures due to minor trauma generally do not present complications. In recent years, a considerable number of studies related to the care and immediate or late complications of this type of injury have been published, which is undoubtedly praiseworthy, since they increasingly inform and guide the professionals involved in such care, characterizing the importance and severity of the injury, especially in polytrauma cases 5, 6, 7, 8, 9. However, a much smaller proportion of publications are related to epidemiological data, regional or otherwise, about fractures and injuries of the pelvic ring, which also have very important information, especially regarding the characterization and appropriateness of care for such an injury 3, 10, 11.…”

Spontaneous Resolution of Pseudoaneurysm of an Iliac Artery Branch in a Multiple Trauma Patient With Pelvic Fracture: Clinical Case

“…Even in large trauma centers, more than 60% of pelvic fractures are stable and do not require surgical stabilization. Among those that do need to be stabilized, most undergo external fixation and only 40% undergo internal fixation (3) …”

“…On the one hand, there has been progress within surgery, with the use of external fixators to reduce unstable pelvic fractures, thereby making it possible to restore mobility to the patient. On the other hand, diffusion of advanced trauma life support (ATLS) theories has contributed towards diminishing mortality among patients with pelvic fractures (3) …”

Resolução espontânea de pseudoaneurisma de ramo da artéria ilíaca em politraumatizado com fratura da bacia - caso clínico

“…On the other hand, diffusion of advanced trauma life support (ATLS) theories has contributed towards diminishing mortality among patients with pelvic fractures (3) .…”