Journal of Trauma and Injury

Original Articles

Perioperative complications of the modified Stoppa approach for the treatment of pelvic bone fractures: a single-institution review of 48 cases: Hyeonjoon Lee, Suenghwan Jo, Gwangchul Lee, Yongjin Cho; J Trauma Inj. 2022;35(1):19-24. Published online November 23, 2021; DOI: https://doi.org/10.20408/jti.2021.0061

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Purpose
The current study aimed to report the perioperative complications of the modified Stoppa approach for the treatment of pelvic bone fractures. Methods: We analyzed 48 consecutive operations in 45 patients who were treated with internal fixation using the modified Stoppa approach between March 2016 and July 2018. This included three revision operations. The mean age of the patients was 54.5 years, and the patients included 35 male patients and 10 female patients. All fractures occurred as a consequence of high-energy trauma and 70.3% had associated injuries at the time of the fracture. The mean Injury Severity Score was 9.03±5.60. The perioperative complications found during and immediately after surgery were recorded and were classified into three categories: vascular injuries, nerve injuries, and other complications. Results: Overall, 14 perioperative complications (29.2%) in 14 cases were identified. The most common complications were nerve injuries, which occurred in seven cases, all involving the obturator nerve. Uncontrollable vascular injuries occurred in six cases, which required additional incisions and support of vascular surgeons or postoperative interventions. Additionally, one case of peritoneal tearing occurred, which required help from an abdominal surgeon. Conclusions: While the modified Stoppa approach seems to be a viable method to treat pelvic fractures, significant perioperative complications may occur, suggesting that surgeons should pay careful attention to minimize the damage to other structures and that appropriate support from other surgical departments is paramount.

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Severe intraoperative vascular bleeding as main complication of acetabular fractures treated with plate osteosynthesis via the modified Stoppa approach
Julia Riemenschneider, Maren Janko, Tilmann Vollrath, Christoph Nau, Ingo Marzi
Injury.2023; 54(7): 110773. CrossRef

Management and Outcome of Patients with Acetabular Fractures: Associated Injuries and Prognostic Factors: Do-Hyun Yeo, Jong-Keon Oh, Jae-Woo Cho, Beom-Soo Kim; J Trauma Inj. 2019;32(1):32-39. Published online March 31, 2019; DOI: https://doi.org/10.20408/jti.2018.016

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Abstract PDF

Purpose

The aim of this study was to determine which factors contribute to the surgical treatment outcomes of acetabular fractures. Simultaneously, we aim to report on the treatment results after our hospital was designated as the focused training center for trauma.

Methods

We conducted a retrospective review of all patients who experienced acetabular fractures from January 1, 2014 to May 1, 2017 and visited our hospital. Patients who had associated pelvic ring fractures or were lost to the one-year follow-up were excluded; a total of 37 fractures were evaluated. We evaluated the clinical results using the scoring system of Merle d’Aubign? (MDA) and grade of Brooker for heterotopic ossification.

Results

Thirty-seven patients (31 men and 6 women) were identified. The mean injury severity score (ISS) was 8.7, with 32.4% of patients having a score >15. The average blood transfusion in the first 24 hours was 0.54 pints. Falling was the most common injury mechanism (32.4%). Chest injury was the most common associated injury (16.2%), followed by head injury (13.5%). The posterior wall and both column fracture were the most common (37.8%) fracture patterns. Excellent and good clinical grades of MDA included 28 patients (75.6%) and fair and poor grades included nine (24.3%), respectively. Four patients were diagnosed with a post-operative infection (10.8%); one out of four patients who had co-morbidity died (2.7%), and another patient underwent a replacement surgery (2.7%). Multivariate analysis showed that age and operation time were associated with MDA. In addition, operation time and ISS were significant co-factors of the Brooker grade.

Conclusions

Korea University Guro Hospital showed similar treatment results of acetabular fractures compared to other publications. The age and operation time were co-factors of the clinical outcome of this fracture. Additionally, increased operation time and injury severity score were suggested to increase the Brooker grade.

Summary

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Outcome of acetabulum fractures treated with open reduction and internal fixation through Kocher-Langenbeck Approach: A retrospective study
Dharmendra Kumar, Narendra Singh Kushwaha, Prakash Gaurav Tiwari, Yashvardhan Sharma, R.N. Srivastava, Vineet Sharma
Journal of Clinical Orthopaedics and Trauma.2021; 23: 101599. CrossRef
FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF ACETABULAR FRACTURES
Sangam Jain, Dishit Vaghasia, Tanay Nahatkar, Spandan Koshire, Amol Salve, Vinod Kumar Yadav
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2021; : 1. CrossRef

Case Reports

Pulmonary Thromboembolism during Acetabular Fracture Operation: Il Seo, Chang-Wug Oh, Joon-Woo Kim, Kyeong-Hyun Park; J Trauma Inj. 2018;31(2):72-75. Published online August 31, 2018; DOI: https://doi.org/10.20408/jti.2018.31.2.72

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Abstract PDF: Acetabular and Pelvic ring fractures are major high-energy trauma injuries and are often combined with other injuries. In particular, cause of long duration of immobilization and combined injuries, venous thromboembolism is a common complication in trauma patients with pelvic or acetabular fractures. We report a case of a fatal pulmonary thromboembolism during the acetabulum fracture operation in a 62-year-old male patient.; Summary

Bilateral Asymmetric Traumatic Dislocation of the Hip Joint: Hee Gon Park, Hyung Suk Yi, Kyoo Hong Han; J Trauma Inj. 2018;31(1):43-50. Published online April 30, 2018; DOI: https://doi.org/10.20408/jti.2018.31.1.43

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Abstract PDF

Traumatic hip joint dislocations account for 2?5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.

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Bilateral Hip Dislocation: Unusual Injury Mechanism
Seyed Mohammad Mousavi, Mojhgan Taghizadeh Mayani, Sayyed Majid Sadrzadeh, Paria Khosravi, Elnaz Vafadar Moradi
Eurasian Journal of Emergency Medicine.2022; 21(1): 73. CrossRef

Original Article

Incidence of Venous Thromboembolism in Pelvic and Acetabular Fractures in the Korean Population: Sang Ki Lee, Jae Won Lee, Jung Joo Hwang; J Trauma Inj. 2013;26(3):74-80.

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Abstract PDF: PURPOSE
There are no detailed reports on the incidence of venous thromboembolism (VTE) in pelvic and acetabular fractures in the Asian population. The purpose of this study was to investigate the incidence of VTE in pelvic and acetabular fractures in the Korean population.
METHODS
The cases of 67 Korean patients with pelvic and acetabular fractures treated at our hospital from January 2009 to February 2012 were analyzed retrospectively. Until May 2010, VTE screening was performed by contrast-enhanced computed tomography (CT) or ultrasonography (US) when the D-dimer value did not decline predictably, still exceeded 20 microg/ml at 5 days after trauma and surgery, or increased to greater than 20 microg/ml after a period of decline. After May 2010, contrast-enhanced CT and US were performed routinely irrespective of the D-dimer value. Physical prophylaxis was performed on all patients. The effects of the presence of a pelvic and/or acetabular fracture, and the effects of fracture type, accompanying injuries, and screening strategies on the incidences of VTE were investigated.
RESULTS
Overall, 26 patients(38.8%) were diagnosed with VTE and PTE in 14(20.9%). All were asymptomatic. Significantly higher incidences of VTE and PTE were observed in trauma patients with pelvic and acetabular fractures than in trauma patients without pelvic and acetabula fractures treated during the same period. No significant differences were observed in the incidences of VTE and PTE between patients with pelvic fractures, and patients with acetabular fractures or between patients with and without accompanying injuries. Compared with the previous screening strategy, the detection rates for VTE and PTE were higher for the newer screening strategy; however, the difference did not reach statistical significance.
CONCLUSION
In the Korean population, we should be vigilant for a high incidence of VTE, especially PTE, in patients with pelvic and acetabular fractures.; Summary

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