Traumatic Hemipelvectomy with a Contralateral Unstable Pelvis and Acetabular Fracture

Abstract

With advancements in resuscitative techniques, carefully timed and planned surgical interventions, and a coordinated multidisciplinary approach, a greater number of patients may be able to survive a massive pelvic injury.

Life-saving therapy for complete traumatic hemipelvectomy: a case report

“…[ 1 ] THP is a rare and catastrophic injury that is usually caused by high-energy trauma, as in a traffic, motorcycle, and machinery-related accident, and is accompanied by pelvic fractures. [ 2 ] THP usually leads to other associated injuries. [ 3 ] The mortality associated with open pelvic fracture is approximately 40%, while the mortality associated with THP may reach as high as 100%.…”

“…[ 4 ] However, few studies describe a standardized approach for handling this fatal trauma. [ 2 ] Here we present a case of complete THP with massive pelvic injuries and severely contaminated wounds associated with neurovascular, colorectal, genitourinary, and soft-tissue injuries. Based on our experience, a rapid and multidisciplinary therapeutic strategy is required to save the patient's life.…”

“…On one hand, an attempt to reimplant the limb could lead to more complications, such as life-threatening hemorrhaging, reperfusion injury, organ failure, acute respiratory distress syndrome, and sepsis. [ 2 ] On the other hand, a leg without motor function or sensation may still be useful for sexual, urinary, anal functions, and has a significant impact on the patient's psychological wellbeing. [ 5 ] To date, there has been no predictive scale or scoring system available for assisting in decision-making in this context.…”

“…[ 5 ] To date, there has been no predictive scale or scoring system available for assisting in decision-making in this context. [ 2 ] In general, immediate hemipelvectomy is recommended as a lifesaving therapy, because extremity-saving approaches incur more risks and increase mortality.…”

“…As regards to this case, which was a complete THP, the decision to retain the limb is difficult and controversial. On one hand, an attempt to reimplant the limb could lead to more complications, such as life-threatening hemorrhaging, reperfusion injury, organ failure, acute respiratory distress syndrome, and sepsis [2] . On the other hand, a leg without motor function or sensation may still be useful for sexual, urinary, anal functions, and has a significant impact on the patient's psychological wellbeing [5] .…”