Emergency Treatment of Multiply Injured Patients with Unstable Disruption of the Posterior Pelvic Ring by Using the “C–Clamp”

Abstract Purpose: Evaluation of the therapeutic usefulness ofthe “pelvic C–clamp” (PCC) during emergency treatmentof multiply injured patients with unstable disruptionof the posterior pelvic ring. Patients and Methods: The data of 28 patients withpolytrauma in combination with an unstable fractureof the posterior pelvic ring (average Injury SeverityScore [ISS]: 49 points; average Polytrauma Score [PTS]:41 points) were retrospectively analyzed from themoment they were admitted to the emergency roomuntil 48 h after admittance. The PCC was used immediatelyfor primary stabilization of the pelvis afterclinical diagnosis of the unstable pelvic fracture. Mainoutcome measurements: development of mean bloodpressure, development of oxygenation level, period oftime until the PCC was placed, number of blood unitsneeded, period of time until circulatory stabilizationoccurred. Results: The PCC was applied in all cases within an averageof 64.7 min after trauma. Seven patients (25%) diedwithin the first 45 min after admission. The survivingpatients showed:• an increase in mean blood pressure of 25% 20 min afterapplication of the PCC,• a hemodynamic stabilization 6 h after application ofthe PCC,• a stabilization of the oxygenation level 6 h after applicationof the PCC,• a decrease in the number of required blood units 6 hafter application of the PCC. Conclusion: The present study shows, that the applicationof the PCC to critically injured patients with unstablepelvic fractures leads to stabilization of the vital parameterswithin a short period of time.