TY - JOUR
T1 - Management of pelvic ring fractures in limited resources country
T2 - a retrospective study
AU - Dilogo, Ismail Hadisoebroto
AU - Gunawan, Bambang
AU - Oesman, Ihsan
AU - Mulyana, Radi Muharris
AU - Silitonga, Jamot
AU - Djaja, Yoshi Pratama
AU - Hartanto, Bernadus Riyan
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
PY - 2022
Y1 - 2022
N2 - Purpose: Pelvic ring fractures (PRFs) management needs adequate facilities and human resources. However, the prehospital ambulance management role in Indonesia is insufficient. Many hospitals have limited resources that necessitate patients to be referred to higher trauma centers. This study aims to describe the state of PRFs management at a level 1 trauma center in limited-resource country. Methods: We conducted retrospective studies of PRFs management from 2011 to 2021 at Cipto Mangunkusumo Hospital. We analyzed patient’s management flow from injury, referral process, initial to definitive treatment, mortality, and Majeed functional score. Results: From 109 patients, 30.3% were non-referrals that came without ambulance, while 69.7% were referrals using an ambulance. All non-referral patients came without pelvic binder with 54.5% unstable hemodynamic, while 35.5% of the referrals came with unstable hemodynamic and 72.4% had pelvic binder. Median time for non-referrals reaching our hospital is 12.5 h. Unlike local referrals, 75% of regional and 85.7% of national referrals general improvement had to be improved before being referred. Polytrauma cases were 33.9% with 12 days mean interval to definitive treatment. Mortality rate in this study was 13.8%. During post-operative follow-up with a mean of 4 years, 83% of patients could be followed up and reported 93 median Majeed score. Conclusion: The management of PRFs at level 1 trauma center in limited-resource country shows a mortality rate of 13.8% through various limitations such as unimplemented ambulance prehospital management, number of patients who were referred without pelvic binder applied, and the long waiting interval for definitive treatment.
AB - Purpose: Pelvic ring fractures (PRFs) management needs adequate facilities and human resources. However, the prehospital ambulance management role in Indonesia is insufficient. Many hospitals have limited resources that necessitate patients to be referred to higher trauma centers. This study aims to describe the state of PRFs management at a level 1 trauma center in limited-resource country. Methods: We conducted retrospective studies of PRFs management from 2011 to 2021 at Cipto Mangunkusumo Hospital. We analyzed patient’s management flow from injury, referral process, initial to definitive treatment, mortality, and Majeed functional score. Results: From 109 patients, 30.3% were non-referrals that came without ambulance, while 69.7% were referrals using an ambulance. All non-referral patients came without pelvic binder with 54.5% unstable hemodynamic, while 35.5% of the referrals came with unstable hemodynamic and 72.4% had pelvic binder. Median time for non-referrals reaching our hospital is 12.5 h. Unlike local referrals, 75% of regional and 85.7% of national referrals general improvement had to be improved before being referred. Polytrauma cases were 33.9% with 12 days mean interval to definitive treatment. Mortality rate in this study was 13.8%. During post-operative follow-up with a mean of 4 years, 83% of patients could be followed up and reported 93 median Majeed score. Conclusion: The management of PRFs at level 1 trauma center in limited-resource country shows a mortality rate of 13.8% through various limitations such as unimplemented ambulance prehospital management, number of patients who were referred without pelvic binder applied, and the long waiting interval for definitive treatment.
KW - Limited resources country
KW - Pelvic ring
KW - Pelvic ring fractures
KW - Pelvis
UR - http://www.scopus.com/inward/record.url?scp=85144660567&partnerID=8YFLogxK
U2 - 10.1007/s00590-022-03457-y
DO - 10.1007/s00590-022-03457-y
M3 - Article
C2 - 36562846
AN - SCOPUS:85144660567
SN - 1633-8065
JO - European Journal of Orthopaedic Surgery and Traumatology
JF - European Journal of Orthopaedic Surgery and Traumatology
ER -