Pelvic Fracture Mok N Ubvq G Zz I Gkwu Kviy T

Pelvic Fracture moK `~N©Ubvq g„Zz¨i GKwU KviY t

wewfbœ AvNvZ RwbZ `~N©Ubv cÖavbZ moK `~N©Ubvq hZ cÖvbnvbx N‡U Zvi cÖvq 5 kZvsk N‡U Pelvic Injury Gi Kvi‡Y| A_P Pelvic Injury m¤ú©‡K A‡b‡KiB †Zgb †Kvb ¯^”Q avibv †bB | `ywU Hip bone Ges sacrum wb‡q †h ew¯’ †`kxq AskwU ˆZwi nq ZvB n‡jv Pelvis.

Bnv Basin like structure hvnv kix‡ii IRb cv‡qi w`‡K enb K‡i Ges A‡bK ¸iæZ¡ c~Y© A½‡K evwn‡ii AvNvZ †_‡K iÿv K‡i|

Pelvic Fracture cÖavb KviY t

i) Road traffic accident (Running vehicle)

ii) Fall from height / any kind of fall.

Type of injury:

i) Isolated fracture with intact pelvic ring.

ii) Fracture with broken pelvic ring

iii) Fracture of acetabulum Acv‡ik‡bi c~‡e©

Dc‡iv³ wZbwU injury Gi g‡a¨ Fracture with broken pelvic ring injury wU me‡P‡q †ewk gvivZ¡K Ges g„Zz¨i Ab¨Zg KviY hvnv †ekxi fvM mgq wPwKrmvi c~‡e©B i³cvZ RwbZ Kvi‡Y g„Zz¨ NUvq|

jÿb t

1| AvNv‡Zi BwZnvm _vK‡e

2| e¨_v (AwZwi³)

3| `vov‡Z bv cviv

4| cÖmªve Ki‡Z Kó n‡e / Ki‡Z cvi‡e bv/ cÖmªv‡ei iv¯Ívq i³

5| Echymosis Pvgovi bx‡P jvj-Kvj‡P `vM Ges dz‡j hvIqv

6| Sock /gyQv© hvIqv

7| iæMx †`L‡Z A‡bK mv`v (Progresive Pale) g‡b n‡e

8| bvoxi (Pulse) MwZ †ewk n‡e

9| i³Pvc K‡g hv‡e

10| cÖavbZ bxP/ Zj †cU dz‡j hvq|

cÖv_wgK wPwKrmv t

cixÿv-wbixÿvi Rb¨ A‡cÿv bv K‡i `ªæZ wPwKrmv ïiæ Ki‡Z n‡e| (ATLS program Abyhvqx)

Ø Saline (Hartman solution / Normal saline)

Ø e¨_v bvkK Jlya

Ø Blood transfusion- BZ¨vw`

Dc‡iv³ wPwKrmvq iæMxi DbœwZ bv n‡j A_ev AviI Lvivc n‡j eyS‡Z n‡e Af¨šÍwib i³cvZ †ekx n‡”Q cÖ‡qvR‡b cixÿv-wbixÿvi cvkvcvwk Laparotomy/ †cU †K‡U i³ cvZ eÜ Kivi e¨e¯’vI wb‡Z n‡e| bZzev i³cvZ RwbZ Kvi‡b g„Zz¨i nvZ †_‡K iÿv Kiv hv‡e bv|

Z‡e evwni †_‡KI i³cvZ e‡Üi e¨e¯’v †bIqv hvq, †hgb- Pelvic compression belt, External fixator Compression BZ¨vw`|

Treatment of Fracture : h_vh_ cÖv_wgK wPwKrmvi gva¨‡g iæMxi Ae¯’vi DbœwZ n‡j ciewZ©‡Z Fracture Gi wPwKrmv Ki‡Z n‡e| fv½vi aib Abyhvqx wPwKrmvi wfbœZv Av‡Q| Av‡Mi w`‡b Pelvic Fracture mvavibZ Acv‡ikb bv K‡iB wPwKrmv Kiv n‡Zv wKš‘ AvaywbK wPwKrmvi hy‡M GLb Avi `xN© w`b weQvbvq ï‡q †_‡K wPwKrmv Kivi cÖ‡qvRb †bB | ZvQvov Non operative treatment Gi A‡bK Amyweav| Aek¨ Acv‡ik‡bi RwUjZvI Kg bq wKš‘ GB RwUjZv ¸‡jv cwinvi †hvM¨ |

Acv‡ik‡bi myweav mg~n t

Ø weQvbvq `xN© w`b ï‡q _vK‡Z nq bv (Early mobilization)

Ø ciwbf©ikxjZv K‡g hvq

Ø `ªæZ Kv‡R wdiv m¤¢e

Ø ¯^vfvweK/ cÖvq ¯^vfvweK Rxeb hvcb|

Acv‡ik‡bi Amyweav mg~n t

Ø Bb‡dKkb- hvnv Ab¨ mKj Acv‡ik‡bI cÖ‡hvR¨

Ø DVT (†h †Kvb Lower limb surgery †Z n‡Z cv‡i)

Ø ARDS

Z‡e DVT & ARDS (k¦vm Kó RwbZ dzmdz‡mi mgm¨v) G mgm¨v Non operative wPwKrmvi †ejv†ZI mgvb fv‡e cÖ‡hvR¨|

mKj w`K we‡ePbv K‡i Pelvic fracture Gi Operative treatment AvaywbK A‡_v©‡cwWK wPwKrmvq GKwU bZzb wmwo hvnv ewntwe‡k¦ Av‡M †_‡K cÖPwjZ _vK‡jI Avgiv wcwQ‡q wQjvg| wKš‘ Avi bq wcwQ‡q _vKv|

Aa¨vcK Wvt Gg AvgRv` †nv‡mb

wPd Kbmvj‡U›U

j¨veGBW nvmcvZvj wjt

avbgwÛ, XvKv|

B-†

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