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.
