More than half of pelvic fractures are accompanied by complications or multiple injuries. The most serious are traumatic hemorrhagic shock and pelvic organ injury. Improper treatment has a high mortality rate.

Treatment of pelvic fracture

1. Marginal pelvic fracture. Stay in bed. Patients with anterior superior iliac spine fracture were placed in hip flexion position; The fracture of ischial tubercle was placed in the straight position of hip joint. Stay in bed for 3-4 weeks.

2. When the pelvic single-ring fracture is separated, it can be fixed by suspension traction with pelvic pocket belt. The pelvic pocket belt is made of thick canvas, the width of which reaches the iliac wing, and the greater trochanter of femur is lowered. It is recommended to lift your hips off the bed surface. After 5-6 weeks, fix it with plaster shorts.

3. In case of longitudinal dislocation of pelvic double-ring fracture, manual reduction can be performed under anesthesia. The reduction method is that when the patient lies on his back, the assistant holds the two lower limbs separately for traction, and the wide cloth belt lined with thick cotton pad resists the traction around perineum to the head side. The operator first gently pushes the iliac bone of the affected side outward to loosen the insertion, then the assistant abducts the affected lower limb under traction, and the operator pushes the iliac crest distally with both hands to correct the upward displacement. At this time, the "click" sound of fracture reduction can be heard, and the patient changes the position of the healthy side. Finally, the patient's sacrum and iliac crest were padded with a thin cotton pad, and the pelvis was fixed with adhesive tape with a width of 1.5 ~ 20 cm. At the same time, the affected limb is continuously pulled by the bone. Bone traction was removed after 3 weeks, and fixation tape was removed after 6 ~ 8 weeks. Exercise quadriceps contraction and joint activity during fixation. You can walk with heavy load after three months.

4. For displaced sacrum or coccyx fracture and dislocation, under local anesthesia, the fracture can be reset by pushing back with fingers through anus. If the pain of old coccyx fracture is severe, it can be blocked locally with prednisolone.

5. For the central dislocation of hip joint, besides the bone traction of the affected limb, unilateral traction should be carried out at the greater trochanter. Reset it.

6. When the dislocation and fracture involving acetabulum cannot be reduced by manipulation, open reduction and internal fixation should be given to restore the articular surface of acetabulum.

Prevention and treatment of shock. Patients often go into shock due to massive retroperitoneal hemorrhage. It is necessary to observe closely that the amount of blood transfusion, infusion and pelvic fracture can reach thousands of milliliters. If the blood pressure continues to drop after actively rescuing a large number of blood transfusions, and the shock cannot be corrected, one or both internal iliac arteries can be ligated or embolized by catheter.