Reconstruction of the pelvis after traumatically induced bilateral partial hemipelvectomy: a case report

Kamitomo, Ayako; Hayashi, Minoru; Tokunaka, Ryohei; Yoshida, Yuki; Sayo, Tatsuta; Sasaki, Yoshi K.

doi:10.1186/s13256-019-2283-5

Cited by 4 publications

(10 citation statements)

References 11 publications

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“…Shrinkage of urinary bladder size due to a long time of exposure and vesicocutaneous fistula towing to complete loss of the urethra from the bladder neck are urinary tract complications, which will be managed by ureteric diversion later on life as the patient and relatives wish. To the best of our knowledge, there were only few cases reported with successful reconstruction with an anterolateral myocutaneous flap [3]. In our case, we preserved the viable soft tissue as much as possible to cover the defect, and the loss of pelvic bone facilitated closure.…”

Section: Discussionmentioning

confidence: 82%

“…Associated injuries, which are common, especially anorectal (60%), genitourinary (85%), and adjacent bony structures, can affect the outcome of these traumas [5]. Early deaths are attributed to hemorrhage or central nervous system injuries, while delayed deaths are due to sepsis and multiple organ failure [3].…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic visceral injuries are well documented with THPs, and the most common associated intra-abdominal injuries after pelvic viscera are injuries to the liver, small bowel, spleen, and diaphragm; these depend on the nature and severity of injury [3].…”

Section: Discussionmentioning

confidence: 99%

“…In our case, we preserved the viable soft tissue as much as possible to cover the defect, and the loss of pelvic bone facilitated closure. Unfortunately, the weight-bearing and maintaining balance with a prosthesis will be decreased [3].…”

Section: Discussionmentioning

confidence: 99%

“…A few victims survive these injuries, and the actual incidence is unknown, but it is usually underestimated [3]. Massive bleeding (approximately 3-4 L) can occur before the venous tamponade's effect, especially if there is significant pubic symphysis diastasis.…”

Section: Introductionmentioning

confidence: 99%

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Use of anterolateral thigh flap for reconstruction of traumatic bilateral hemipelvectomy after major pelvic trauma: a case report

et al. 2020

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Background Major pelvic trauma (MPT) with traumatic hemipelvectomy (THP) is rare, but it is a catastrophic health problem caused by high-energy injury leading to separation of the lower extremity from the axial skeleton, which is associated with a high incidence of intra-abdominal and multi-systemic injuries. THP is generally performed as a lifesaving protocol to return the patient to an active life. Case report A 12-year male patient exposed to major pelvic trauma with bilateral THP survived the trauma and multiple lifesaving operations. The anterolateral thigh flap is the method used for wound reconstruction. The follow-up was ended with colostomy and cystostomy with wheelchair mobilization. To the best of our knowledge, there have been a few bilateral THP reports, and our case is the second one to be successfully treated with an anterolateral thigh flap. Conclusion MPT with THP is the primary cause of death among trauma patients. Life-threatening hemorrhage is the usual cause of death, which is a strong indication for THP to save life.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of anterolateral thigh flap for reconstruction of traumatic bilateral hemipelvectomy after major pelvic trauma: a case report

et al. 2020

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Case series of two successful pelvic ring reconstructions using a pedicled anterolateral thigh flap

2021

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Open pelvic ring fractures can have devastating functional consequences including prolonged disability, chronic pain, infection, and even death. These injuries are uncommon but often involve soft tissue defects. Without early and appropriate coverage, patients are likely to sustain infection, which can be fatal. Here, we present the successful use of a pedicled ALT flap in two patients with soft tissue defects due to open pelvic ring injury. The pedicled ALT flap can be harvested as a composite flap comprising a portion of the skin, fascia, and muscle depending on the defect. Although the ALT flap has often been employed for abdominal wall and abdomino-perineal reconstruction, this is the first case series to report the use of the ALT flap in a subacute traumatic setting for pelvic ring reconstruction.

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Management of a large traumatic hemipelvectomy defect following a truck crush injury: a case report

Temizsoy

2024

Ulus Travma Acil Cerrahi Derg

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This case report explores the management of a traumatic hemipelvectomy—a rare and devastating injury characterized by a high mortality rate. The patient, a 12-year-old male, suffered right lower extremity amputation and right hemipelvectomy due to a degloving injury from a non-vehicle-related accident at another institution. Initially, an urgent reconstruction of the right pelvic region and suprapubic tissue defects was performed using a posterior-based fasciocutaneous flap. Following this, the patient was transferred to the pediatric intensive care unit at our hospital with a suspected diagnosis of necrotizing fasciitis. Treatment included broad spectrum antibiotics and multiple debridements to avert the onset of sepsis. Eventually, reconstruction of a 60 x 25 cm defect covering the lower back, abdomen, gluteal, and pubic regions was achieved through serial split-thickness skin grafts and a pedicled anterolateral thigh flap. The patient made a remarkable recovery, regained mobility with the aid of a walker, and was discharged in good health 22 weeks after the initial accident. This case report underscores the importance of serial debridements in preventing sepsis, the use of negative pressure vacuum dressing changes, the initiation of broad-spectrum antibiotics based on culture results during debridements, and prompt closure of the defect to ensure survival after traumatic hemipelvectomy. Familiarization with the principles discussed here is crucial to minimizing mortality rates and optimizing outcomes for this rare injury.

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Reconstruction of the pelvis after traumatically induced bilateral partial hemipelvectomy: a case report

Cited by 4 publications

References 11 publications

Use of anterolateral thigh flap for reconstruction of traumatic bilateral hemipelvectomy after major pelvic trauma: a case report

Use of anterolateral thigh flap for reconstruction of traumatic bilateral hemipelvectomy after major pelvic trauma: a case report

Case series of two successful pelvic ring reconstructions using a pedicled anterolateral thigh flap

Management of a large traumatic hemipelvectomy defect following a truck crush injury: a case report

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