Damage Control Orthopaedics (DCO) Theory Application In The Treatment Of Unstable Pelvic Fracture

ObjectiveThis paper mainly discusses the multiple severe trauma of unstable pelvic fractures in patients with the best treatment strategy;damage control orthopedics(DCO)theory application in the treatment of unstable pelvic fracture and its necessity and impor-tance.MethodA retrospective analysis of February 2013 October 2015 in DCO under the guidance of the theory of treatment of 35 cases of severe multiple trauma of unstable pelvic fractures in patients with clinical data in the treatment group(including TILE type,ISS score,Majeeed score,injury cause,injury after definitive operation time,complicatio ns and mortality).The control group in January 2008 January 2013 were not according to the DCO principle for the treatment of pelvic fractures in 45 cases.The group of patients with unstable pelvic injury after admission to give positive assessment of fracture,if the condition allows one to general surgical treatment,if not allow active symptommatic treatment,surgical treatment in stable condition after the follow-up and record the clinical data.The patients in the treatment group were treated with DCO is divided into three stages: the main purpose of the first stage of treatment for the control of primary injury(acute hemorrhagic shock,infection,control,injury fixation etc.)The second stage is the recovery phase of injury,to life organ maintenance,blocking the "death triad",to create conditions for the two phase of the definitive operation..The third stage is the stage of definitive surgery.Two groups of patients were given routine postoperative anterop osterior radiographs,entrance examination,according to the Lindahl imaging criteria for evaluating pelvic fracture reduction.Postoperative rehabilitation training and actively guide patients to correctly establi sh the long-term follow-up evaluation,according to the criteria of Majeed after operation.The statistical data were statistically analyzed using SPASS19.0 statistical software,using SPSS 19 statistical software,count data was expressed as%,t test,P<0.05 shows statistically significant difference.resultThe treatment group of 35 patients died in 2 patients during the treatment,33 cases of postoperative survival(survival rate 94%).The survival of patients with postoperative complications occurred in 7 cases(21%),including 3 cases of infection,anti infection were cured;2 cases of malunion fracture;1 cases of ARDS,1 cases of ventilator rehabilitation after treatment;lower extremity deep venous thrombosis.The death of patients,2 cases died of acute hemorrhagic shock.Follow up of 33 cases of patients received postoperative survival(6-20mon-ths),Majeed score 85.21+ 4.53,Lindahl evaluation of the excellent rate was 90%(excellent in 17 cases,13 cases were good,3 cases).The death of 45 patients in the control group of 5 cases during the treatment,40 cases of postoperative survival(survival rate 89%),17 cases of postoperative complications in patients with survival(42%),9 cases of deep infection and anti infection were cured;2 cases of malunion;3 cases of ARDS,ventilator rehabilitation after treatment;2 cases of lower extremity deep vein thrombosis;1 cases of intestinal obstruction.The death of patients,2 cases of patients with pelvic organ injury,died of hemorrhagic shock;1 cases with left lower extremity crush injuries,died of acute renal failure;1 cases died;1 cases died of DIC MODS.40 patients were followed up(6-24 months),Majeed score was 80.68+5.24,Lindahl evaluation of the excellent rate was 72.5%(excellent in 11 cases,18 cases were good,11 cases).The DCO group and the control group of patients with Majeed score and Lindahl evaluation,the excellent and good rate of compl-ications,admission from deterministic operation time.There was sign-ificant difference,ISS score,age,sex,type of fracture,injury causes no significant.Conclusion1.Unstable pelvic fractures were caused by traffic accidents,and more complicated with abdominal and pelvic organs injury.2.For patients with unstable pelvic fracture with multiple severe injuries,the DCO theory can effectively reduce the mortality rate,improve the cure rate and reduce the postoperative complications.3.Patients with unstable pelvic fractures were treated with DCO theory,although the duration of hospitalization was longer than that of the conventional treatment strategy,the excellent rate of postoperative Lindahl evaluation and Majeed score were higher than that of the patients with unstable pelvic fractures.