Pelvic C-clamp in a pediatric patient
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Published on: September 13, 2022
Ginger E Holt1, Gregory A Mencio
1Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232-2550, USA.
Insights
The pelvic C-clamp offers safe, temporary posterior fixation for pediatric pelvic ring injuries with severe hemorrhage. This method avoids growth plate disruption, unlike anterior external fixators.
Area of Science:
- Orthopedic surgery
- Pediatric trauma care
- Emergency medicine
Background:
- Pediatric pelvic ring injuries are rare but can cause life-threatening hemorrhage.
- Anterior external fixators are effective but complex for emergency use in children.
- The pelvic C-clamp was developed for temporary posterior pelvic stabilization in adults.
Observation:
- A skeletally immature patient with a posterior pelvic ring injury and massive hemorrhage was treated.
- The pelvic C-clamp was applied for temporary posterior fixation.
- The C-clamp provided fixation without compromising physeal growth areas.
Findings:
- The pelvic C-clamp proved to be a safe and effective temporary fixation method.
- This approach successfully managed posterior pelvic ring instability and associated hemorrhage.
- It offers a simpler alternative to anterior external fixators in pediatric emergencies.
Implications:
- The pelvic C-clamp may be a valuable tool for managing pediatric pelvic ring injuries with hemorrhage.
- It provides a less invasive and quicker fixation option compared to traditional methods.
- Further studies are warranted to evaluate its long-term outcomes in pediatric populations.
Abstract:
The pelvic C-clamp was designed to provide posterior stability temporarily to pelvic ring injuries associated with massive venous hemorrhage in adult patients. Pediatric pelvic ring injuries are uncommon, but when unstable injuries occur they may be coupled with visceral injuries and lethal hemorrhage. 1, 2 Anterior external frame fixators have been described in the treatment of these injuries in pediatric patients with few adverse outcomes and good long-term results. Although they provide adequate fixation, anterior frame application is complicated, time-consuming, and cumbersome as an emergency application. The pelvic C-clamp eliminated these problems, while providing fixation points that do not violate areas of cartilage or physeal growth. We present a case demonstrating that the pelvic C-clamp is a safe form of temporary fixation in a skeletally immature patient with a posterior pelvic ring injury associated with massive hemorrhage.
