Emergency stabilization of the pelvic ring: Clinical comparison between three different techniques

Area of Science:

• Trauma Surgery
• Orthopedic Surgery
• Emergency Medicine

Background:

• Emergency devices for pelvic ring stabilization include sheets, binders, and c-clamps.
• Limited data exists on the comparative outcomes of these stabilization techniques.

Purpose of the Study:

• To compare the demographic and injury characteristics and outcomes of pelvic fracture patients treated with circumferential sheets, pelvic binders, or c-clamps.
• To evaluate the effectiveness of different emergency pelvic ring stabilization devices in reducing lethal pelvic bleeding.

Main Methods:

• A retrospective analysis of 6137 patients from the German Pelvic Trauma Registry (2004-2012).
• 207 patients treated with sheets, binders, or c-clamps were analyzed for demographic data, injury characteristics, and outcomes.
• Outcome parameters included packed red blood cell transfusion, hospital stay, mortality, and incidence of lethal pelvic bleeding.

Main Results:

• C-clamps were most frequently used (69%), followed by sheets (16%) and binders (15%).
• Sheet wrapping was associated with a significantly higher incidence of lethal pelvic bleeding (23%) compared to binders (4%) or c-clamps (8%).
• No significant differences were found in transfusion requirements, hospital stay, or mortality between the groups.

Conclusions:

• Emergency pelvic ring stabilization with binders and c-clamps is associated with a lower incidence of lethal pelvic bleeding compared to sheet wrapping.
• These findings suggest that binders and c-clamps may be preferable for emergency pelvic stabilization to reduce severe hemorrhage.