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2020, vol. 37, br. 1, str. 23-33
Povrede karličnog prstena
Univerzitet u Nišu, Medicinski fakultet + Klinički centar Niš, Klinika za ortopediju

e-adresasasaortoped@gmail.com
Ključne reči: karlični prsten; povrede; hirurško lečenje
Sažetak
Karlica je jaka koštano-ligamentarna struktura koja sadrži mnoge organe, krvne sudove i nerve. Tri sile, ili njihova kombinacija, izazivaju prelome karlice. Glavni uzrok preloma karlice su saobraćajni udesi ili pad sa visine. Biomehanički, karlični prsten može biti stabilan ili nestabilan. Biomehanički nestabilan karlični prsten može da provocira hemodinamsku nestabilnost. Stopa mortaliteta kod hemodinamski nestabilnih bolesnika sa prelomima karlice ostaje visoka. Hemodinamski nestabilni bolesnici zahtevaju hitno zatvaranje karličnog volumena pomoću karlične C kleme ili pomoću spoljašnjeg fiksatora. Ovakva fiksacija obično je privremena. Masivna venska krvarenja iz povređene karlice zahtevaju tamponadu karlice, dok arterijsko krvarenje zahteva angiografiju i embolizaciju. Po stabilizaciji hemodinamskog statusa bolesnika, dalja evaluacija podrazumeva mehaničku stabilizaciju karlice. Definitivna stabilizacija karlice uključuje hemodinamski stabilnog bolesnika i podrazumeva prednju ili zadnju fiksaciju ili i prednju i zadnju fiksaciju karličnog kompleksa. Glavna indikacija za to da je potrebno izvršiti prednju stabilizaciju je dijastaza pubične simfize za više od 2,5 cm. Prednja stabilizacija postiže se spoljašnjom fiksacijom ili simfizealnim pločama. Primarna indikacija za to da je potrebno uraditi zadnju stabilizaciju karličnog kompleksa je vertikalna nestabilnost karlice. Stabilna mehanička fiksacija može se postići prednjim sakroilijačnim pločama, perkutanim iliosakralnim zavrtnjima i transilijačnim sakralnim barovima. Neadekvatan tretman povreda karlice može da izazove trajnu invalidnost i ozbiljne hronične poremećaje.
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O članku

jezik rada: engleski
vrsta rada: pregledni članak
DOI: 10.5937/afmnai2001023M
objavljen u SCIndeksu: 15.06.2020.
metod recenzije: dvostruko anoniman
Creative Commons License 4.0

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