The formulating and clinical significance of partial traumatic hemipelvectomy score / 中华骨科杂志

ABSTRACT

Objective To conclude partial traumatic hemipelvectomy score and assess its value in partial traumatic hemipelvectomy treatment.Methods Data of the managements of 14 partial traumatic hemipelvectomy patients between January 2003 and December 2015 were retrospectively analyzed.10 of these patients were males and 4 females,with an average age of 31 (range,21-55).11 patients were brought directly to the hospital emergency department,and 3 patients were transferred from other hospitals.According to Tile classification system,all pelvic fractures were type C fracture:nine with type C 1,three with type C2 and two with type C3.Partial traumatic hemipelvectomy score was concluded according to soft tissue injury severity,the distance between hemi-pelvic and body axis,injury degree of iliac vessel and nerve.All these factors were further classified into four grades (range,1-4) on the basis of injury severity.Based on clinic outcomes and our experiences,hemipelvectomy should be performed at the early stage when patients had scores more than 12;if the score was between 8 and 12,reassessment should be done according to practical situation and hemipelvectomy was recommended;if the score was between 4 and 8,limb salvage was strongly recommended;if the score was below 4,limb salvage should be done.Results All 14 patients were assessed by partial traumatic hemipelvectomy.The average score was 11 (range,9-14).12 of them were scored at the range of 9-12.2 of them had scores more than 12.3 patients died during the initial resuscitation stage.7 patients underwent completion of the hindquarter amputation after control of hemorrhage and all the patients were successfully survived.Limb preservation was attempted in 4 patients:3 of them died eventually because of infection.1 patient underwent hip disarticulation in emergency operation,but this patient eventually required hindquarter amputation for severe infection.Conclusion Partial traumatic hemipelvectomy score could be a rapid and accurate tool in initial assessment of partial traumatic hemipelvectomy.After the control of hemorrhage,early hemipelvectomy could lower the death rate of this kind of patients.