Pelvic emergency clamps: anatomic landmarks for a safe primary application

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Unstable pelvic ring fractures require rapid stabilization.
• Current surface landmarks for pelvic clamp pin placement are unreliable due to swelling and hematoma.
• Pelvic C-clamp application is a critical, life-saving emergency procedure.

Purpose of the Study:

• To identify reliable bony landmarks for pelvic C-clamp pin insertion in emergency settings.
• To improve the safety and efficiency of pelvic clamp application for unstable pelvic ring fractures.

Main Methods:

• Retrospective review of 43 emergency pelvic C-clamp applications.
• Identification and validation of a specific bony landmark on the lateral cortex of the ileum.
• Utilized blunt palpation with an instrument to locate the landmark.

Main Results:

• A reliable "groove" landmark on the lateral cortex of the ileum was identified for optimal pin placement.
• This landmark allows for precise pin insertion, close to the sacroiliac joint, enabling maximum posterior pelvic ring compression.
• The technique facilitated identification even in emergency situations with swelling and hematoma, often avoiding fluoroscope use.

Conclusions:

• The described bony landmark on the ileum provides a reliable and easily palpable insertion point for pelvic C-clamp pins.
• This technique enhances the safety and efficiency of emergency pelvic fracture stabilization.
• The identified landmark is crucial for minimizing complications and optimizing treatment outcomes in pelvic ring injuries.