To log-roll or not to log-roll – That is the question! A review of the use of the log-roll for patients with pelvic fractures

Rodrigues, Inês Filipa da Cunha

doi:10.1016/j.ijotn.2017.05.001

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…[20] In the context of unstable pelvic fractures, movement should be limited to prevent the dislodging of any clot resulting in haemodynamic compromise. [21] In imaging of the thoracolumbar region, CT is proven to be more sensitive in the detection of compression fractures in the context of osteoporosis. [22] It would be imperative to exclude the presence of fragments that might lead to retropulsion into the spinal canal leading to spinal cord injury.…”

Section: Cervical/thoracic/lumbar Spinementioning

confidence: 99%

Does a fall from a standing height warrant computed tomography in an elderly patient with polytrauma?

Chowdhury¹

2023

World Journal of Emergency Medicine

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Section: Cervical/thoracic/lumbar Spinementioning

confidence: 99%

Does a fall from a standing height warrant computed tomography in an elderly patient with polytrauma?

Chowdhury¹

2023

World Journal of Emergency Medicine

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“…Logrolling examination aims to identify soft tissue injury of the back, and clinical diagnosis sensitivity of thoracolumbar fracture is very low of 27.5% only 22 . The alternative is to inspect the bed sheet for bleeding hints and placement of the gloved hands gently underneath the back to palpate for any major wounds or bony deformity 23 …”

Section: Commandment 2—do Not Rock the Pelvis To Check Stability Avoi...mentioning

confidence: 99%

“…22 The alternative is to inspect the bed sheet for bleeding hints and placement of the gloved hands gently underneath the back to palpate for any major wounds or bony deformity. 23…”

Section: Commandment 1-before the Abcde Steps Preparedness Protection...mentioning

confidence: 99%

The 10 commandments of exsanguinating pelvic fracture management

Law¹,

Lau

Ahmad

et al. 2019

Hong Kong Journal of Emergency Medicine

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Background: Unstable pelvic fractures are highly lethal injuries. Objective: The review aims to summarize the landmark management changes in the past two decades. Methods: Structured review based on pertinent published literatures on severe pelvic fracture was performed. Results: Ten key management points were identified. Conclusion: These 10 recommendations help diminish and prevent the mortality. (1) Before the ABCDE management, preparedness, protection, and decision are essential to optimize patient outcome and to conserve resources. (2) Do not rock the pelvis to check stability, avoid logrolling but prophylactic pelvic binder can be life-saving. (3) Computed tomography scanner can be the tunnel to death for hemodynamically unstable patients. (4) Correct application of pelvic binder at the greater trochanter level to achieve the most effective compression. (5) Choose the suitable binder (BEST does not exist, always look for BETTER) to facilitate body examination and therapeutic intervention. (6) Massive transfusion protocol is only a temporizing measure to sustain the circulation for life maintenance. (7) Damage control operation aims to promptly stop the bleeding to restore the physiology by combating the trauma lethal triad to be followed by definitive anatomical repair. (8) Protocol-driven teamwork management expedites the completion of the multi-phase therapy including external pelvic fixation, pre-peritoneal pelvic packing, and angio-embolization, preceded by laparotomy when indicated. (9) Resuscitation endovascular balloon occlusion of aorta can reduce the pelvic bleeding while awaiting hospital transfer or operation theater access. (10) Operation is the definitive therapy for trauma but prevention is the best treatment, comprising primary, secondary, and tertiary levels.

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“…However, patient mortality is not always caused directly by the fractures themselves; major organ injuries, hemodynamic instability, and infection are possible causes [ 1 , 2 ]. Unstable pelvic ring injuries and internal bleeding, especially those caused by arterial mass hemorrhage, considerably increase mortality [ 3 , 4 ]. Therefore, controlling serious hemorrhages, stabilizing fractures, and avoiding urinary tract injuries are interventions critical to decreasing associated mortality rates [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Risk of Mortality and Readmission among Patients with Pelvic Fracture and Urinary Tract Infection: A Population-Based Cohort Study

Chen

Chuang

Hsieh

et al. 2021

IJERPH

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Patients with pelvic fractures could encounter various complications during or after treatments. This cohort study investigated the risk of mortality and readmissions in patients with pelvic fractures, with or without urinary tract infections (UTIs), within 30 days following the pelvic fractures. This retrospective cohort study examined claim records from the Longitudinal Health Insurance Database 2000 (LHID2000). We selected patients hospitalized with pelvic fractures between 1997 and 2013 for study. Patients who had index data before 2000 or after 2010 (n = 963), who died before the index date (n = 64), who were aged <18 years (n = 94), or who had a pelvic injury (n = 31) were excluded. In total, the study cohort comprised 1623 adult patients; 115 had UTIs, and 1508 patients without UTIs were used as a comparison cohort. Multivariate analysis with a multiple Cox regression model and Kaplan–Meier survival analysis were performed to analyze the data. Our results showed that the 1-year mortality rate (adjusted hazard ratio [HR]: 2.32; 95% CI: 1.25–4.29) and readmission rate (adjusted HR: 1.72; 95% CI: 1.26–3.34) of the UTI group were significantly higher than those of the non-UTI group. Moreover, the Kaplan–Meier curve for the 1-year follow-up indicated that the UTI group had a higher cumulative risk of both mortality and hospital readmission compared with the non-UTI group. In conclusion, among patients with pelvic fracture, patients with UTI were associated with increased risks of mortality and readmission. Physicians must pay more attention to such patients to prevent UTIs among patients with pelvic fractures during hospitalization and conduct a follow-up after discharge within at least 1 year.

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To log-roll or not to log-roll – That is the question! A review of the use of the log-roll for patients with pelvic fractures

Cited by 6 publications

References 30 publications

Does a fall from a standing height warrant computed tomography in an elderly patient with polytrauma?

Does a fall from a standing height warrant computed tomography in an elderly patient with polytrauma?

The 10 commandments of exsanguinating pelvic fracture management

Risk of Mortality and Readmission among Patients with Pelvic Fracture and Urinary Tract Infection: A Population-Based Cohort Study

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