Improving the improvisational pelvic circumferential compression technique for open-book pelvic fractures using a...

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Orthopedic Trauma

Background:

• Open-book pelvic fractures carry high mortality rates.
• Emergency management often requires pelvic circumferential compression devices.
• Commercial devices may be unavailable; bedsheets are an alternative but can be limited by patient or rescuer factors.

Purpose of the Study:

• To evaluate the effectiveness of an improvisational windlass (intravenous pole) in enhancing pelvic fracture reduction.
• To determine if an improvised device improves compression force compared to standard methods.

Main Methods:

• A study involving 28 healthcare students and residents used a METIman model.
• Participants applied a bedsheet for pelvic compression, first with maximum manual effort, then with an added intravenous pole as a windlass.
• Pressure measurements were recorded after each application method.

Main Results:

• The mean pressure increase with a bedsheet alone was 106.43 mm Hg.
• The mean pressure increase with the bedsheet and improvised windlass was 351.79 mm Hg.
• This difference was statistically significant (p < 0.001), with no correlation to participant physical characteristics.

Conclusions:

• An improvisational windlass significantly enhances the effectiveness of bedsheet pelvic circumferential compression.
• This technique improves fracture reduction capabilities, particularly beneficial for obese patients or when rescuer strength is limited.
• The improvised windlass offers a valuable, accessible tool for managing open-book pelvic fractures.