Emergency pelvic external stabilization as the first step treatment in high risk pelvic fractures

Abstract

We evaluated the clinical effectiveness of emergency pelvic external stabilization (EPES) as a first step of resuscitation and pelvic stabilization in trauma patients with hemodynamic and/or fracture instabilities. METHODS Twenty-three patients (12 males, 11 females; mean age 32 years; range 9 to 67 years) with high risk pelvic fractures underwent EPES. The presence of a systolic blood pressure equal to or below 90 mmHg, vertical and/or rotational instabilities, or fractures at risk were defined as high risk fractures. Pelvic fractures were assessed according to the Tile’s classification. RESULTS Hemodynamic instability was detected in 10 patients. The mean durations to the elective pelvic stabilization were three days (range 2 to 8 days) and 17.7 days (range 7 to 28 days) in patients with or without hemodynamic instability, respectively. The mean duration for EPES application was below 30 minutes (range 20 to 40 minutes). No deaths occurred due to blood loss caused by pelvic fractures. One patient died due to sepsis 14 days after hemodynamic stabilization. Superficial pin-track infections of grade 1 were detected in five patients, four of whom were treated with local dressings. In one patient, two pins had to be replaced because of loosening. CONCLUSION Emergency pelvic external stabilization for resuscitation and high risk fracturesis an effective intervention in the acute phase of polytraumatized patients presenting with high risk pelvic fractures.