The Formulating And Clinical Significance Of Partial Traumatic Hemipelvectomy Score

Objective:Conclude partial traumatic hemipelvectomy score(PTHS)and assess its value in partial traumatic hemipelvectomy treatment.Methods:We retrospectively studied the management of 14 partial traumatic hemipelvectomy patients Between January 2003 and December 2015.10 of these patients were male and 4 of these were female,at mean age of 31(range,21-55).11 patients were brought directly to the hospital emergency department,and 3 patients were transferred from another hospital.According to AO classification system,all pelvic fractures were with type C fracture:nine with type Cl,three with type C2 and two with type C3.We conclude partial traumatic hemipelvectomy score 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 early stage when patients had scores more than 12;if 8<score?12,reassessment according to practical situation and performe hemipelvectomy when necessary;if 4<score?8,try best to do limb salvage;if score?4,perform limb salvage.Results:All 14 patients were assessed by PTHS.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.For clinical result,3 patients died during the initial resuscitation phase.7 patients underwent completion of the hindquarter amputation after control of hemorrhage.All these patients 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.