Sudden Accident Life in the Balance
Recently, a 53-year-old worker, Liu, fell from a height while working and was subsequently sent to the emergency department of Nanjing Traditional Chinese Medicine Hospital by ambulance. Imaging indicated a severe pelvic and right acetabular fracture, which is classified as a serious trauma that often endangers the patient’s life due to associated soft tissue and vascular nerve injuries and severe bleeding. The surgical difficulty is recognized as one of the most complex and challenging orthopedic trauma surgeries.
Director Zhang Chunlei of the Orthopedic Department evaluated the patient and developed a meticulous surgical plan. The top-tier trauma orthopedic surgery was completed in 4.5 hours. During the surgery, Director Zhang employed a dual surgical incision approach combining the anterior iliac-groin route with the posterior K-L route, successfully performing a delicate dissection to protect critical anatomical structures such as the spermatic cord, lateral femoral cutaneous nerve, femoral nerve, femoral artery and vein, sciatic nerve, superior gluteal artery, and inferior gluteal artery, achieving perfect reduction and strong internal fixation of the complex, comminuted, and unstable fracture.
（▲Preoperative patient and 3D printed model）
Moreover, through collaboration with Director Cheng Dawen’s interventional team, a right iliac artery balloon occlusion was performed preoperatively, and the anesthesia team led by Han Chuanlai implemented intraoperative hypotension control techniques, keeping intraoperative bleeding under 500ml. Preoperatively, Director Zhang also utilized 3D printing technology to create a 1:1 scale 3D model of the pelvis, which facilitated strict preoperative planning, exemplifying the integration of medicine and engineering and precision medical surgery.
（▲Postoperative pelvic X-ray review）
Postoperatively, to prevent common complications associated with pelvic fractures, symptomatic treatments were provided to prevent heterotopic ossification and infection. Currently, the patient is recovering well, with stable vital signs and a return to work on the horizon.
Expert Introduction
Zhang Chunlei
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MD, Chief Physician, Doctoral Supervisor. A key figure in the Jiangsu Province “333 Project” for cultivating young and middle-aged academic leaders, Deputy Director of the Orthopedic Department at Nanjing Traditional Chinese Medicine Hospital, and Director of the Trauma Orthopedic Center.
He has led 7 provincial and municipal research projects, received two third prizes for municipal scientific and technological progress, one second prize for excellent natural science papers at the municipal level, holds 4 national patents, co-edited one monograph, and published 6 SCI papers as the first or corresponding author, with a total impact factor (IF) of 25, and a highest single paper IF of 11.4. He has published over 20 papers in core journals.
Current positions:
Executive member of the Orthopedic Professional Committee of Jiangsu Province Association of Integrative Medicine,
Member of the Trauma Medicine Branch of Jiangsu Province Medical Association,
Member of the Orthopedics Branch of Jiangsu Province Medical Association, Joint Surgery Group,
Member of the Bone Tumor Group of Jiangsu Province Medical Association,
Member of the Orthopedics Branch of Jiangsu Province Geriatrics Association,
Member of the Orthopedics Branch of Nanjing Medical Association,
Member of the Joint Surgery Group of Nanjing Medical Association,
Executive member of the Trauma Medicine Branch of the China Association of Traditional Chinese Medicine.
Main Research Directions and Professional Technical Expertise:
1. Surgical treatment of pelvic acetabular fractures and complex limb fractures, management of major compound injuries.
2. Hip and knee joint replacement and revision surgeries, minimally invasive preservation of the femoral head and correction of limb deformities, arthroscopic minimally invasive surgeries, and bone and joint fusion and reconstruction surgeries.
3. Standardized diagnosis and treatment of bone and soft tissue tumors, tumor prosthesis replacement, and limb function reconstruction surgeries.
4. Surgical treatment of spinal cord tumors and infections, cervical spondylosis, lumbar disc herniation, lumbar spondylolisthesis, spinal fractures, and spinal cord injuries with paralysis, as well as correction surgeries for spinal degenerative deformities.
Professional Review: Zhang Chunlei
Text and Image Editor: Mo Yufan
Reviewed and Published: Zhang Ming