Famous Among Top Surgeons in the 90s

Xie Wanying believed that these words did not need to be said by her; Zhang Wei, who had experienced today’s encounter, would figure it out on her own.

Turning around, Xie Wanying softly said to Student Wei, who was assisting, "She probably has a pelvic fracture. When lifting her, be extremely careful and stabilize her pelvic area."

Wei Shangquan was frightened just hearing the words pelvic fracture.

Pelvic fracture leaves a deep impression as the most dangerous trauma for those who have seen severely injured car accident victims on the clinical front. This is because from an anatomical perspective, there are too many organs involved inside and around the pelvis. If the fractured end is exposed with a sharp point, it can easily puncture organs within or near the pelvis, leading to hemorrhagic shock. For such severely injured patients with pelvic fractures, the time doctors have to save them and stop the bleeding is usually less than six hours.

After being startled, Wei Shangquan observed the injured: Hey, no shock?

"She might have a compression fracture, a Type A in the Tile classification, so there’s no internal bleeding for now," Xie Wanying quietly communicated with her classmate. These words should not be overheard by the injured person to avoid unnecessary panic.

Pelvic fractures are commonly classified into four types using the Young-Burgess classification method, aiming to differentiate the severity of the injury and guide prognosis. According to this classification principle, the most severe among the four types is the anteroposterior compression type, also known as the separation type. The separation type mainly refers to the separation of the pubic symphysis. Such separation easily leads to a rupture of the ligaments maintaining the pelvis, causing a chain reaction with severe bleeding, thus making this type have the highest mortality rate.

The compression type fracture mentioned by Student Xie, which is actually the lateral compression type, is the most common type of pelvic fracture, accounting for half of the total, with a lower mortality rate than the separation type.

The best scenario, ideally, refers to another classification of pelvic fractures, as mentioned by Student Xie again, the Tile classification. The Tile classification divides into Types A, B, and C. This classification method categorizes fractures based on whether the bones have displaced and their stability after the fracture. Type A is undoubtedly the best, involving slight movement with the fractured bones continuing to remain stable.

As long as the bone can basically remain in its original stable position, without breaking entirely and exposing sharp ends, and without injuring nearby organs, it can avoid bleeding. Resting quietly and allowing the fracture to heal slowly on its own is sufficient.

The prerequisite for achieving this step is to stabilize the pelvis, ensuring no secondary damage to the pelvis.

This is why laypeople understand not to move casualties on the scene recklessly. As you are not a professional, you are unable to judge the condition of this injured person or how to move them. It’s not that the injured cannot be moved, but that moving them must adhere to proper medical treatment pathways.

What kind of casualties are the hardest to move? If you’ve studied pre-hospital emergency care, you know that various fracture victims are the most difficult to assess, the hardest to move safely, and the most prone to secondary injuries.

On-site rescuers need to take a deep breath, coordinate their thoughts and then take appropriate transport measures.

Student Wei had a question about this: How did Student Xie determine it was a pelvic fracture? It’s known that the injured person complained about their left leg being pinned down, so the most severe injury should have been the left leg.

The injured person’s left leg was under pressure, but upon prying open the car panel, it was found to be only scraped, with no obvious swelling or bruising on the calf. Instead, when the injured person bent their leg, they moaned, and combined with the patient’s sitting posture being awkward, clearly sitting in pain and unable to support themselves, these all hinted at a potential pelvic issue.

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