Pelvic and Complex Trauma

Complex Pelvic Surgery

Pelvic fracture is a disruption of the bony structure of the pelvis, including the hip bone, sacrum and coccyx. The most common cause in the elderly is a fall, but the most significant fractures involve high-energy forces such as a motor vehicle crashes, cycling accidents, or a fall from significant height. Another cause can be the result of pregnancy and/or childbirth causing mild to complete disruption/instability of the pelvic joints symphysis pubis, sacroiliac joint. Diagnosis is made on the basis of history, clinical features and special investigations usually including X-ray and CT. Because the pelvis cradles so many internal organs, pelvic fractures may produce significant internal bleeding which is invisible to the eye. Emergency treatment consists of advanced trauma life support management. After stabilisation, the pelvis may be surgically reconstructed.

Previous surgery, radiation therapy, infection and endometriosis can often cause significant scarring or adhesions in the pelvic tissues making pelvic surgery more complex. Injury to surrounding anatomic structures is a more common complication when there is scarring present. Surgeons need specialty training and should have experience in performing these more challenging surgeries to minimize the risks of damage to surrounding tissue.

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