Comprehensive emergency managements and early stabilization are pivotal upon treating complex pelvic and acetabular fractures. A thorough operative strategy is required to determine the best operative approach based on the patient’s general condition, available facilities, and surgeon preferences in such complex fracture configuration. Advanced technique of the fixation is necessary during a skillful execution of surgery in order to achieve good treatment results. An 18-years-old female crushed by a bus upon crossing street, presented with hypovolemic shock with ISS polytrauma score 50 consisting of right acetabular associated both column fracture, bilateral pelvic fracture anteroposterior compression type 3, and coccygeal fracture with bilateral drop foot. She underwent emergency laparotomy, had her ovary, bladder, and intestine primarily sutured, and then we immobilized the pelvic using anterior frame external fixator, which was maintained for 6 days. Upon stable condition, we performed right ilioinguinal approach and modified Stoppa with lateral window for the left side, while Kocher-Langenbeck technique was used to approach the posterior acetabular column. Postoperative radiology showed an adequate internal fixation in both right acetabular columns, successful reconstruction of pelvic ring which was fixated the left ischium, left superior and inferior pubic rami, and full restoration of left sacroiliac joint disruption. Majeed pelvic outcome score was 54, while Hannover pelvic outcome score was good and the patient was able to sit without pain 2 months postoperative. Management of complex pelvic-acetabular-coccygeal fracture requires a holistic chain of treatment by emphasizing the prompt emergency management, accurate preoperative planning, and excellent execution of reconstructive surgical strategy to achieve satisfactory outcome.
Case Rep Orthop Res 2021;4:192–201

中文翻译：

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严重多发伤患者合并柱髋臼骨折 Judet-Letournel 型和尾骨骨折的复杂骨盆骨折的处理

综合应急管理和早期稳定对于治疗复杂的骨盆和髋臼骨折至关重要。在这种复杂的骨折结构中，需要根据患者的一般状况、可用设施和外科医生的偏好，制定全面的手术策略来确定最佳手术方法。在熟练的手术过程中，需要先进的固定技术才能达到良好的治疗效果。一名 18 岁女性在过马路时被公共汽车压伤，出现低血容量性休克，ISS 多发伤评分 50，包括右侧髋臼相关双柱骨折、双侧骨盆骨折前后压缩 3 型和尾骨骨折伴双侧足下垂。她接受了紧急剖腹手术，主要缝合了卵巢、膀胱和肠道，然后我们使用前架外固定器固定骨盆，保持6天。病情稳定后，我们采用右侧髂腹股沟入路，左侧采用改良的Stoppa侧窗入路，同时采用Kocher-Langenbeck技术入路髋臼后柱。术后放射学显示右侧髋臼柱内固定充分，固定左侧坐骨、左侧耻骨上下支的骨盆环重建成功，左侧骶髂关节断裂完全修复。Majeed 骨盆结果评分为 54，而 Hannover 骨盆结果评分良好，患者能够在术后 2 个月无疼痛地坐下。
案例代表 Orthop Res 2021；4:192–201