https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:22809 Wed 11 Apr 2018 14:49:43 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:22724 Wed 11 Apr 2018 11:25:52 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:41114 Tue 26 Jul 2022 08:55:17 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:15479 Sat 24 Mar 2018 08:19:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10753 24 hours). Demographics, Injury Severity Score, pelvic Abbreviated Injury Score, first 24-hour transfusions, physiologic parameters, time to operating room (OR), angiography requirement, length of stay (LOS), and mortality were recorded. Data are presented as mean ± SD or percentages. Statistical significance was determined at p < 0.05 based on univariate analysis. Results: Forty-five patients met inclusion criteria, 18 patients had acute definitive ORIF (5.5 hours to OR) and 27 had late definitive ORIF (5 days to OR). Acute and late ORIF patients had comparable demographics (age: 48 ± 22 years vs. 40 ± 14 years, gender: 82% vs. 79% men) and injury severity (Injury Severity Score: 30 ± 18 vs. 24.5 ± 13, pelvic Abbreviated Injury Score: 3.7 ± 1 vs. 3.4 ± 1.1). Initial shock parameters were significantly worse in the acute ORIF group (systolic blood pressure, 69.7 ± 17 mm Hg vs. 108 ± 21 mm Hg; BD, −7.4 ± 4 vs. −4.9 ± 2 mEq/L, lactate 6.67 ± 7 mmol/L vs. 2.51 ± 1.3 mmol/L). Angiography was used in 18% (3/18) vs. 21% (6 of 27) of the cases. All early ORIF patients survived and one (3%) of the late ORIF patients died. There was a trend to shorter hospital LOS (25 ± 24 days vs. 37 ± 32 days) and a decreased 24-hour red cell transfusion rate (4.7 ± 5 U vs. 6.6 ± 4 U) in the early ORIF group. The intensive care unit admission rate (12 of 18 vs. 15 of 27) and LOS was comparable (2.9 ± 2.5 days vs. 3.7 ± 3.6 days). Conclusion: Acute ORIF of unstable pelvic ring fractures within 6 hours could be safely performed even in severely shocked patients with multiple injuries. The procedure did not lead to increased rates of transfusion, mortality, intensive care unit LOS, or overall LOS. Furthermore, all these parameters showed a trend toward benefit compared with a staged approach.]]> Sat 24 Mar 2018 08:08:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:18143 Sat 24 Mar 2018 08:04:45 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:18382 Sat 24 Mar 2018 07:52:42 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:51579 5 years = 79%). Topics in the questionnaire included surgical and interventional treatment strategies, classification, staging/reconstruction procedures, and preoperative imaging. Answer options for treatment strategies were ranked on a 4-point rating scale with following options: (1) always (A), (2) often (O), (3) seldom (S), and (4) never (N). Stratification was performed according to geographic regions (continents). Results: The Young and Burgess (52%) and Tile/AO (47%) classification systems were commonly used. Preoperative three-dimensional (3D) computed tomography (CT) scans were utilized by 93% of respondents. Rescue screws (RS), C-clamps (CC), angioembolization (AE), and pelvic packing (PP) were observed to be rarely implemented in practice (A + O: RS = 24%, CC = 25%, AE = 21%, PP = 25%). External fixation was the most common method temporized fixation (A + O = 71%). Percutaneous screw fixation was the most common definitive fixation technique (A + O = 57%). In contrast, 3D navigation techniques were rarely utilized (A + O = 15%). Most standards in treatment of unstable pelvic ring injuries are implemented equally across the globe. The greatest differences were observed in augmented techniques to bleeding control, such as angioembolization and REBOA, more commonly used in Europe (both), North America (both), and Oceania (only angioembolization). Conclusion: The Young-Burgess and Tile/AO classifications are used approximately equally across the world. Initial non-invasive stabilization with binders and temporary external fixation are commonly utilized, while specific haemorrhage control techniques such as pelvic packing and angioembolization are rarely and REBOA almost never considered. The substantial regional differences’ impact on outcomes needs to be further explored.]]> Mon 11 Sep 2023 14:29:03 AEST ]]>