Comparison of pelvic C-clamp and pelvic binder for emergency stabilization and bleeding control in type-C pelvic ring fractures

被引:15
|
作者
Audretsch, Christof K. [1 ]
Mader, Daniel [1 ]
Bahrs, Christian [1 ]
Trulson, Alexander [2 ]
Hoech, Andreas [3 ]
Herath, Steven C. [4 ]
Kueper, Markus A. [1 ,5 ]
机构
[1] Univ Tubingen, Dept Traumatol & Reconstruct Surg, BG Trauma Ctr, Schnarrenbergstr 95, D-72076 Tubingen, Germany
[2] BG Trauma Ctr, Dept Trauma Surg, Murnau, Germany
[3] Univ Leipzig, Dept Orthoped Trauma & Plast Surg, Leipzig, Germany
[4] Saarland Univ Hosp, Dept Trauma Hand & Reconstruct Surg, Homburg, Germany
[5] Eberhard Karls Univ Tubingen, Fac Med, Tubingen, Germany
关键词
MANAGEMENT; HEMORRHAGE; CLASSIFICATION; EPIDEMIOLOGY; TRAUMA;
D O I
10.1038/s41598-021-81745-z
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Severe bleeding is the major cause of death in unstable pelvic ring fractures. Therefore, a quick and efficient emergency stabilization and bleeding control is inevitable. C-clamp and pelvic binder are efficient tools for temporary bleeding control, especially from the posterior pelvic ring. Yet the C-clamp requires more user knowledge, training and equipment. However, whether this makes up for a more efficient bleeding control, is still under debate. Patients with a type-C pelvic ring fracture were identified from the German Pelvic Registry (GPR) and divided into three groups of 40 patients (1. no emergency stabilization, 2. pelvic binder, 3. C-clamp). The matching occurred according to the parameters age, gender, initial RR and initial HB. Complication-and mortality rates were compared especially regarding bleeding control. Regarding ISS and fracture dislocation there was no difference. The use of the C-clamp resulted in more complications, a higher mortality rate due to severe bleeding and more blood transfusions were admitted. Moreover the pelvic binder was established noticeably faster. However, the C-clamp was more often rated as effective. There is no evidence of advantage comparing the C-clamp to the pelvic binder, regarding bleeding control in type-C pelvic ring fractures. In fact, using the pelvic binder even showed better results, as the time until established bleeding control was significantly shorter. Therefore, the pelvic binder should be the first choice. The C-clamp should remain a measure for selected cases only, if an adequate bleeding control cannot be achieved by the pelvic binder.
引用
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页数:8
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