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Stammverletzung: Becken

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Management des Schwerverletzten

Zusammenfassung

Beckenringverletzungen im Jugend- und Erwachsenenalter sind immer Zeichen eines hochenergetischen Traumas. Die Erstbehandlung dieser Patienten ist auf den Erhalt oder die Wiederherstellung der hämodynamischen Stabilität fokussiert. Eine klinische Untersuchung der Beckenstabilität und der den Beckenring umgebenden Weichteile sind unerlässlich. Die Sequenz der klinischen und apparativen Diagnostik sowie der therapeutischen Maßnahmen hängt vom hämodynamischen Zustand des Patienten ab. Klare Indikationen müssen für die Anwendung unterschiedlicher invasiver und nichtinvasiver Methoden zur Stabilisierung des Beckenrings und der intrapelvinen Blutungen eingehalten werden (Beckentuch, Beckengurt, Beckenklemme, Fixateur externe, Beckentamponade bei hämodynamischer Instabilität). Bei unbeherrschbaren Blutungssituationen können interventionelle Methoden, wie eine selektive Angioembolisation (bei arteriellen Verletzungen) oder eine temporäre Ballonokklusion der Aorta (Damage-Control-Rettungsmaßnahme), zur Anwendung kommen. Trotz adäquater Versorgung bleibt die Mortalität und Morbidität nach schweren Verletzungen des Beckenrings hoch.

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Authors and Affiliations

  1. Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Johannes Gutenberg-Universität, Langenbeckstraße 1, 55131, Mainz, Deutschland

    Prof. Dr. med. Dr. h.c. P. M. Rommens

  2. Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Johannes Gutenberg- Universität, Langenbeckstraße 1, 55131, Mainz, Deutschland

    MME, PD Dr. med. S. Kuhn

  3. Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz Klinikum, Hellmut-Hartert-Straße 1, 67655, Kaiserslautern, Deutschland

    Prof. Dr. med. A. Hofman

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  1. Prof. Dr. med. Dr. h.c. P. M. Rommens
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  2. MME, PD Dr. med. S. Kuhn
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  3. Prof. Dr. med. A. Hofman
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Correspondence to P. M. Rommens , S. Kuhn or A. Hofman .

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  1. Universitätsspital Zürich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Klinik für Unfall- und Wiederherstellung, Universitätsklinikum RWTH Aachen, Aachen, Deutschland

    Frank Hildebrand

  3. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Marburg, Marburg, Deutschland

    Steffen Ruchholtz

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Rommens, P.M., Kuhn, S., Hofman, A. (2018). Stammverletzung: Becken. In: Pape, HC., Hildebrand, F., Ruchholtz, S. (eds) Management des Schwerverletzten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54980-3_16

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