Emergent treatment of pelvic fractures. Comparison of methods for stabilization.
The emergent care of an unstable pelvic ring disruption in the patient who is hemodynamically unstable includes rapid application of military antishock trousers or an external fixator in an attempt to control bleeding and hemodynamically stabilize the patient. However, use of the military antishock trousers is limited in that it restricts access to the abdomen and lower extremities. The external fixator is limited at many institutions by the need to apply it in the operating room. Two experimental devices have been developed to provide emergent pelvic fracture reduction and temporary stabilization in the trauma room, while maintaining access to the abdomen and lower extremities. This study compared the efficacy of pelvic fracture reduction and stabilization in a cadaveric model using an external fixator with the efficacy of 2 experimental devices, the pelvic stabilizer and the pelvic c-clamp. Based on their ability to restore pelvic volume and reduce pubic diastasis and their application time, the 3 devices performed similarly. Complications in applying each device were noted but were of less clinical significance for the external fixator. Surgeon practice on cadavera before clinical use will help ensure safe application of either experimental device in the trauma room.