Marcus Mohr

Emergent management of pelvic ring fractures with use of circumferential compression.

Circumferential compression of the pelvis has been recommended for emergent stabilization of open-book pelvic fractures to reduce the risk of life-threatening hemorrhage 1-3. However, little information on the application, effectiveness, and safety of this procedure is available to date 3,4. We therefore investigated noninvasive stabilization of pelvic ring fractures in three cadaveric biomechanical studies. First, we established optimal application parameters for circumferential compression of open-book pelvic fractures. Second, we derived the amount of pelvic stabilization that can be achieved by application of a novel pelvic sling that provides for controlled circumferential compression. Finally, we determined whether this pelvic sling could be applied safely at the emergency scene, where the specific pelvic fracture pattern is not readily assessable. The results of this research demonstrate that circumferential compression with this noninvasive pelvic sling is an effective and safe method for reducing and stabilizing open-book pelvic fractures at the emergency scene. Application Parameters: A cadaveric study was performed to determine the most effective application site and the force required to reduce open-book pelvic fractures. Partially stable and unstable open-book pelvic fractures (Young-Burgess type-II and III anteroposterior compression fractures associated with a 50 and 100-mm diastasis of the symphysis pubis, respectively) were created sequentially in seven nonembalmed human cadavers from individuals with an average age at death of 80 ± 7 years, an average height of 170 ± 9 cm, and an average weight of 74 ± 8 kg Fig. 1 . An experimental pelvic sling consisting of a 50-mm wide, flexible, nonelastic belt was designed. This sling was applied at three distinct …