Effectiveness of conservative treatment on adult pelvis fracture

Yıl 2013, , 108 - 115, 04.03.2014

Turan Taş , Seyfi Tezeren Zekeriya Öztemur Volkan Güneyli Kansu Çilli

https://doi.org/10.12808/bcs.v2i3.33

Öz

Abstract

Aim. In this study, clinical outcome of long-term conservative treatment on adult pelvis fractures were evaluated. Methods. Adult patients (n=75) admitted to the Emergency and Orthopedics and Traumatology Services of Cumhuriyet University Hospital for major pelvic trauma from 2000 to 2007 were retrospectively studied. All patients were treated with various conservative methods.  Results. Of the study population, 31, 11, and 33 patients were Tile Types A, B, and C, respectively. Subsequent to the treatment, patients were evaluated by IPS scoring system and excellent, good, medium, and bad results in 44, 17, 7, and 7 patients, respectively, were obtained. Conclusions. In this study, conservative treatment was performed in all the patients. Long-term hospital stay and long-term recovery was prominent in the Tile Type C managed with a success rate of 81.4%. Conservative treatment has been considered as safe and effective in Tile Types A and B fractures. Although the popularity of surgical treatment in Tile Type C fractures has been increasing, when the surgical risks are considered, conservative treatment may be also alternative treatment method.

Keywords: Pelvis fracture, conservative treatment, long-term outcome, orthopedic major trauma.

Özet

Amaç. Bu çalışmada, erişkin pelvis kırıklarında konsevatif tedavinin uzun dönem sonuçları değerlendirildi. Yöntem. Cumhuriyet Üniversitesi Hastanesi Acil Servisi ve Ortopedi Servisine 2000–2007 yılları arasında başvuran major pelvik travması olan 75 erişkin hasta retrospektif olarak incelenmiştir. Bulgular. Hastaların 31 tanesi Tile Tip A, 11 tanesi Tile Tip B, 33 tanesi ise Tile Tip C pelvik kırık olgusu idi. Tüm hastalar çeşitli konservatif tedavi yöntemleri ile tedavi edildi. Tedavi sonrasında hastalar IPS skorlama sistemine göre değerlendirildi ve 44 hastada mükemmel, 17 hasta da iyi, 7 hasta da orta, 7 hasta da ise kötü sonuçlar elde edildi. Sonuçlar. Bu çalışmada tüm gruplara konservatif tedavi uygulanmıştır. Her ne kadar Tile Tip C grubunda uzun yatış süresi ve normal yaşama dönüş süresinin uzun olması gibi bir takım olumsuzluklar olmasına rağmen % 81.4 oranında başarılı sonuçlar elde edilmiştir. Tile Tip A ve Tip B kırıklarda konservatif tedavi etkili ve güvenli bulunmuştur. Tile Tip C kırıklarda ise cerrahi tedavi popülerliliğini giderek artırmasına rağmen, cerrahi riskler göz önüne alındığında, konservatif tedavi de alternatif bir tedavi yöntemi olduğu düşünülmelidir.

Anahtar sözcükler: Pelvis kırığı, konservatif tedavi, uzun dönem sonuç, ortopedik major travma

Anahtar Kelimeler

Pelvis fracture, conservative treatment, long-term outcome, orthopedic major trauma.

Kaynakça

• Hammel J, Legome E. Trauma reports. A case-based approach to contemporary management. J Emerg Med 2006; 30: 87–92.
• Tintinalli JE, Kelen GD, Stapczynski JS. Trauma to the pelvic, hip and femur. In: Steele MT, Ellison SR, editors. Emergency Medicine. A Comprehensive Study Guide. 6th ed. New York. McGraw-Hill; 2004. p: 1712–1726.
• Petrisor BA, Bhandari M. Injuries to the pelvic ring, incidence, classification, associated injuries and mortality rates. J Cuor 2005; 19: 327–333
• Chenney K. The management of pelvic trauma in the emergency department. AENJ 1999; 2: 14–18.
• Peitzman AB, Rhodes M, Schwab CW, Yealy DM, Fabian TC. Pelvic fractures. In: Prayson MJ, Gruen GS, editors: Trauma Manual. 2nd. ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p: 311–318.
• Chapman MW: Fractures and dislocations of the pelvic ring. In: Mears DC, Durbhakula SM, editors: Chapman's Orthopaedic Surgery. 3rd. ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p: 532–535.
• Richard CH, James VN, Jorge GC : Non-operatively Treated Major Traumatic Pelvic Disruptions: An evaluation of the long-term results . Iowa Orthop J. 1986; 6: 100– 10
• Canale ST, Azar FM, Beaty JH, Calandrucio JH, et al. Campbell’s Operative Orthopaedics. In: Canale ST, Akgün I, editors: Pelvis kırıkları. 10. basım; 2007. s: 2962–2980
• Adams JE, Davis GG, Heidepriem RW 3rd, Alonso JE, Alexander CB. Analysis of the incidence of pelvic trauma in fatal automobile accidents. Am J Forensic Med Pathol. 2002 Jun;23(2):132-6.
• Inaba K, Sharkey PW, Stephen DJ, Redelmeier DA, Brenneman FD. The increasing incidence of severe pelvic injury in motor vehicle collisions. Injury. 2004 Aug;35(8):759-65.
• Starr AJ: Immediate management of pelvic fractures. Oper Orthop Traumatol 2003; 13: 73–78.
• Wolfson AB, Hendey GW, Hendry PL, et al.: Pelvic Fractures. In: Gibbs MA, Tibbles CD, editors:. Harwood-Nuss' Clinical Practice of Emergency Medicine. 4th. ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p: 1071–1078.
• Nepola JV, Trenhaile SW, Miranda MA, Butterfield SL, Fredericks DC, Riemer BL. Vertical shear injuries: Is there a relationship between residual displacement and functional outcome? J Trauma 1999; 46: 1024–1030
• Yair B, Meir L, Ori S, Amal K, Rami M. Pelvis fractures in a level 1 trauma center. A test case for the efficacy of the evolving trauma system in Israel. IMAJ 2005; 7: 619–622.
• Yıldız M, Gedikli A, Durukan P, Bulut M, Çevik Y, Yılmaz E. Pelvis kırıklı hastaların 115