Abstract
IntroductionUnstable fractures of the pelvis remain the predominant cause of severe hemorrhage, shock and early death in severely injured patients. The use of pelvic binders has become increasingly popular, particularly in the preclinical setting. There is currently insufficient evidence available about the stability of the pelvic binder versus supraacetabular fixation using 1 or 2 Schanz screws. We aimed to analyze the stability of the pelvic binder and supraacetabular fixateurs using either 1 or 2 Schanz screws in a cadaver model of an induced pelvic B-type fracture.Materials and methodsThe study was undertaken in 7 human fresh-frozen cadaveric pelvises with induced AO-type B fractures. Three stabilization techniques were compared: T-POD (pelvic bandage), supraacetabular external fixator with 1 pin on each side and external fixator with 2 pins on each side. Stability and stiffness were analyzed in a biomechanical testing machine using a 5-step protocol with static and dynamic loading, dislocation data were retrieved by ultrasound sensors at the fracture sites.ResultsNo significant differences in fracture fragment displacement were detected when using either the T-POD, a 1-pin external fixator or a 2-pin external fixator (P > 0.05). The average difference in displacement between the three methods was < 1 mm.ConclusionsPelvic binders are suitable for reduction of pelvic B-type fractures. They provide stability comparable to that of supraacetabular fixators, independently of whether 1 or 2 Schanz screws per side are used. Pelvic binders provide sufficient biomechanical stability for transferring patients without the need to first replace them with surgically applied external fixators. However, soft tissue irritation has to be taken into consideration and prolonged wear should be avoided.Level of evidenceLevel III
Highlights
Unstable fractures of the pelvis remain the predominant cause of severe hemorrhage, shock and early death in severely injured patients
Pelvic binders are suitable for reduction of pelvic B-type fractures
Pelvic binders provide sufficient biomechanical stability for transferring patients without the need to first replace them with surgically applied external fixators
Summary
Unstable fractures of the pelvis remain the predominant cause of severe hemorrhage, shock and early death in severely injured patients. The use of pelvic binders has become increasingly popular, in the preclinical setting. There is currently insufficient evidence available about the stability of the pelvic binder versus supraacetabular fixation using 1 or 2 Schanz screws. Emergency fixation of unstable fracture patterns of the pelvis should fulfill various criteria such as reduction of intrapelvic volume and stable preliminary reduction in order to control the associated bleeding and hemorrhagic shock [1]. There is evidence that pelvic binders lead to sufficient preliminary reduction and, control of the bleeding [2]. There is currently insufficient evidence regarding the timing of removal the pelvic binder and whether or not the stability is sufficient for longer timeframes. Other studies report deleterious effects on the soft tissues, including necrosis with later soft tissue coverage, the assessment of the pelvis in terms of complex pelvic trauma is limited as is the nursing management on ICU [3, 4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
