Trends and efficacy of external emergency stabilization of pelvic ring fractures: results from the German Pelvic Trauma Registry.
Bleeding control
External stabilization
Haemorrhage control
Multiple trauma
Pelvic fracture
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
25
01
2019
accepted:
15
05
2019
pubmed:
24
5
2019
medline:
16
10
2021
entrez:
24
5
2019
Statut:
ppublish
Résumé
External emergency stabilization (EES) of unstable pelvic fractures reduces haemorrhage and mortality. Available are non-invasive procedures (sheet sling and pelvic binder) and invasive procedures (external fixator and pelvic C-clamp). Nevertheless, there is no recommended standard as to which procedure for EES should be used. Prospectively collected data between 2007 and 2016 from the German Pelvic Trauma Registry were used to evaluate 989 patients with in-hospital EES. Besides age, gender and injury severity score (ISS), the fracture classification was evaluated. Furthermore, the frequency of used EES, time to application, their reported efficacy and the frequencies of change to another EES were investigated. The use of pelvic binders increased up to 40% while all other procedures decreased in frequency over the 10-year period. The ISS was highest in patients treated with a pelvic C-clamp or combination of pelvic C-clamp and external fixator (p < 0.05). Non-invasive stabilization was applied significantly faster than invasive procedures (p < 0.0001). Overall, the reported efficacy was good (at least 70%) for all procedures but with poorest results for the pelvic binder and best for the external fixator (p < 0.00001). Most change to another EES was found for the sheet sling and pelvic binder. In case of suspected unstable pelvic fracture, an EES should be performed, in case of doubt with a non-invasive EES until imaging and final diagnosis. Which method should be used depends on the individual situation and the available information about the overall injury pattern. Invasive EES are preferable for treatment according to Damage Control Orthopaedics.
Identifiants
pubmed: 31119322
doi: 10.1007/s00068-019-01155-9
pii: 10.1007/s00068-019-01155-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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