Fracture Malgenya is one of the types of damage to the pelvic bones.
All fractures of the pelvic bones are classified by their severity, and the amount of damage received is also taken into account. The aforementioned injury is one of the most severe fractures and, according to the classification of pelvic injuries, it belongs to type C. In the absence of timely medical care, the injury practically in any case leads to death.
Anatomical features of the pelvic bones
The pelvis is formed by two bones: nameless or those. Each of these bones, in turn, is formed by three bones fused together - the iliac, sciatic, pubic. These bones are fused in adolescence.
The pelvic bones are connected to each other, forming a ring. The walls of this ring represent protection for the organs located inside it, in addition, it is an element of support for the entire human body.
On both sides, the pelvic ring is divided into two half rings by acetabulums:
- The rear half-ring is located behind the acetabulum. It includes the posterior part of the ilium, the ilio joints, the sacrum.
- The front half-ring is located in front of the acetabulum. It is formed by the symphysis and branches of the pubic bones.
The stability of the pelvis is provided, first of all, by a semicircle located behind. With a fracture of Malgen, two pelvic half rings are damaged. Damage can be unilateral or bilateral, accompanied by a rupture of ligaments. With such an injury, the pelvis turns back or forth and moves up.
Causes of pathology
Malgeny fracture can occur as a result of extremely intense exposure to damaging force, which is directed to the lateral surfaces of the pelvic bones.
This can happen in the following cases:
- when under the rubble that has arisen as a result of the collapse of residential premises, convergence of an avalanche;
- major rail or car accidents;
- falling from a very great height.
That is, it is an uncommon injury, but it is characterized by severe manifestations and a high frequency of deaths.
Symptoms
In most cases, with a Malgen fracture, the patient is in an extremely serious condition. The victim has symptoms of pain, hemorrhagic shock:
- Significant drop in blood pressure.
- Threaded or rapid pulse.
- Oppression of consciousness.
- Isolation of cold, sticky sweat.
- Pallor of the skin.
Among the characteristic signs of a similar injury to the pelvic bones are the following:
- Severe pain on palpation of the pelvic area.
- Swelling, the occurrence of an increasing hematoma in the sacrum and perineum.
- Asymmetric arrangement of bony pelvic protrusions.
Malgen fracture of the pelvis is accompanied by the formation of a large retroperitoneal hematoma. Spilled blood can reach the level of perinephric fiber. As a result of this phenomenon, palpation of the abdomen allows you to detect the symptoms of peritoneal irritation - a positive symptom of Shchetkin, board-like muscle tension.
A characteristic sign of such an injury is severe dysfunction of the lower extremities. Fragments of bones can damage organs located in the pelvis - the uterus in women, the rectum, and the bladder. As a result of injuries, pelvioperitonitis can develop, which is an inflammatory process in the pelvic peritoneum.
Fracture diagnosis
To clarify the diagnosis of a fracture such as Malgen, a traumatologist prescribes an X-ray examination. A picture is taken when the patient is lying on his back, while his legs should be extended. This position allows you to provide an overview of all pelvic structures. A more accurate study is carried out by computed or magnetic resonance imaging.
Therapies for this pathology
How to treat a pelvic fracture such as Malgen? Therapeutic measures for such an injury are divided as follows:
Each stage has a specific instruction for conducting therapeutic measures.
Prehospital care
A double fracture of the pelvic bones is accompanied by pain shock and the occurrence of massive bleeding. Therefore, pre-hospital care is to minimize all movements of the victim. The patient is transported using a wooden shield or a hard stretcher.
To immobilize the patient, traumatologists use special suits or transport tires. During transportation, intensive hemostatic and anti-shock therapy is performed.
Treatment of a fracture of the Malgen pelvis in a hospital
The main therapy begins with the elimination of conditions that threaten the patient's life. Hemodynamics should be stabilized, blood loss compensated, and the injured part of the body anesthetized.
To eliminate pain shock, an intra-pelvic blockade according to Shkolnikov is shown. The doctor, using a long needle, inserts Novocain into the iliac fossa. This technique allows not only to fully anesthetize the injured area, but also to stop bleeding.
The main technique for treating a pelvic fracture of the Malgen type is to reposition the displaced pelvic half rings. For this purpose, the patient is placed in a hammock, and then, using the Beler splint, skeletal traction of the pelvis for the condyles of the femur is carried out. A sixteen kilogram load is suspended on one side, and a load weighing up to 6 kilograms is suspended on the other. Traction takes an average of 8-9 weeks. Giving a full load on the lower limbs is allowed no earlier than 4.5 months later.
The most effective method of therapy, which allows to shorten the period of immobilization, is bone osteosynthesis using metal plates. After such surgery, patients are allowed to get up after a couple of weeks.
What is the rehabilitation period?
Rehabilitation activities should begin in the hospital. Their main goal is to facilitate the well-being of the victim, accelerate his recovery.
The main areas of rehabilitation are physiotherapeutic procedures, therapeutic exercises and massage.
In addition, patients with pelvic fractures need to fully eat, and the diet should be enriched with minerals, vitamins, calcium. Every day, the patient should consume dairy products.
Additionally, calcium can be obtained using drugs such as Calcium-D3, Calcemin. In addition to the named element, they also contain vitamin D, which contributes to better absorption of calcium in bone tissue.
The prognosis for this pathology
The prognosis of the outcome of such an injury greatly depends on the correctness and timeliness of the provision of medical care. In Malgen fracture, the patient died, but most injuries have a favorable outcome.
After an injury, the patient may develop some complications. These include:
- Complications during pregnancy and childbirth in women.
- Pathology of the pelvic organs.
- Neurodystrophic disorders.
- Gait disorders.
- Chronic form of pain.
Thus, Malgen fracture requires urgent hospitalization and intensive care.