The Clinical Research Of The Damage Control Orthopedicsin The Treatment Of Unstable Pelvic Fractures

Background and objective Damage control orthopedics refers to department of orthopedics method which control the disease rather than the implementation of deterministic emergency trauma is repaired, then the theory is widely used in order to make up for the American guns caused trauma treatment needs. In 1983 Stone was did 17 cases of severe trauma patients with early simplified operation, recovery and undergoing deterministic operation, which achieved good results. simple operation that trauma early implementation of damage control, which can save the critically ill patients who is difficult to save.The damage control surgery(damage control surgery, DCS) concept In recent years. DCS is widely used in the treatment of severe trauma and multiple trauma,which made great progress. Unstable pelvic fractures are common in fall, traffic accident, crush injury and other high energy injury, usually accompanied by other corresponding parts damage, such as the rectum and bladder, urethral, nerve injury, especially department of the pelvic organs injury.Severe bleeding can lead to shock,which may cause DIC, low body temperature, metabolic acidosis,which is a fatal fracture. Therefore,the damage introduced DCO theory is very necessary in the extreme state. Damage control orthopedics philosophy(damage control orthopedics,DCO) in the perioperation periodis refers to method of comprehensive application of multi-subject, a series of measures to improve the diagnosis and treatment effectively, especially the operation method, the maximum reduce mortality and surgical patients with stress, which reduce the risk of surgery and complications, so as to accelerate postoperative recovery, improve rehabilitation quality, shorten the hospitalization time of the fundamental purpose. The core connotation is as much as possible to reduce even block the surgical operation which have dominated the stress response of wounded treatment operation result. As one of the principles of trauma treatment philosophy and science’s at present, Department of orthopedics, damage control philosophy was applied in clinical practice than the traditional idea that show better treatment effect, and in all subjects of science spread very quickly from the original mainly in orthopedic application gradually expanded to almost all surgical field. But so far there is a department of orthopedics, damage control is mainly used in critically ill trauma department of orthopedics, damage control reports and application value in the emergency surgery. this paper discusses the damage control orthopedics in unstable pelvic fracture application value and prospect., there were statistically significant differences between the compared group(P < 0.05). MethodsFrom 2013.1 to 2014.6, patients with unstable pelvic fractures and admitted in th e Emergency Care Center of The First Affiliate Hospital of Zhengzhou University we re collected. Patients were classified according to disease category, every classificatio n of patients were divided into damage control orthopedics(DCO)group and conservat ive treatment surgery(CTS)group randomly.Biochemical and clinical markers of the t wo groups were collected and compared. Statistical analysis Statistical treatment is completed wih SPSS 13.0 package.Measurement data is expr essed by mean( x)±standard deviation(s), according to measurement data, group com parison between groups using t- test, ANOVA is used in comparision within repeated measurement data set, the group ratio comparision is analyzed by chi-square,Compa rison between groups of level data is analyzed by rank test. P< 0.05 for the difference was statistically significant. Results1.the patient sparticipated in the study in DCO group of 2 cases(4%), CTS grou p of 6 cases(10%) because of the heavy injury, died during the treatment period. 99 c ases were followed-up successfully, The mean followed-up time(14±4.9) months. Th ere were no deaths during follow-up(excluding extraneous factors and primary diseas e).2.There were no significance difference of preoperative PH,BE,T,FDP,D-DT, W BC,CRP,ESR, PCT,age and gender composition between groups(P>0.01).3.Compared with DCO group, FTS group have a lower PH,BE,T,FDP,D-DT,W BC,CRP,ESR,PCT(P < 0.05).4.Compared with DCO group, FTS group have a lower complication rate and ho spital cost,a shorter time of bowel function recovery, first postoperative ingress and h ospital stay,(P < 0.05).5.Compared with DCO group, FTS group have a lighter WHO pain rating scale.(P < 0.05).6.Compared with DCO group, FTS group have a lowerthe excellent and good rat e,there were statistically significant differences between the compared group.(P < 0.05). ConclusionsDCO is a safe and effective perioperative treatment measure for patients with un stable pelvic fractures who need emergency operation.DCO can reduce the mortality of patients, shorten the gastrointestinal function recovery time and hospitalization tim e, reduce postoperative complications and hospitalization expenses.