title: Emergent stabilization of pelvic ring injuries by controlled circumferential compression: a clinical trial.
abstract: BACKGROUND
  Pelvic ring injuries are associated with a high incidence of mortality mainly due to retroperitoneal hemorrhage. Early stabilization is an integral part of hemorrhage control. Temporary stabilization can be provided by a pelvic sheet, sling, or an inflatable garment. However, these devices lack control of the applied circumferential compression. We evaluated a pelvic circumferential compression device (PCCD), which allows for force-controlled circumferential compression. In a prospective clinical trial, we documented how this device can provide effective reduction of open-book type pelvic injuries without causing overcompression of lateral compression type injuries.
  
  
  METHODS
  Sixteen patients with pelvic ring injuries were enrolled. Pelvic fractures were temporarily stabilized with a PCCD until definitive stabilization was provided. Anteroposterior pelvic radiographs were obtained before and after PCCD application, and after definitive stabilization. These radiographs were analyzed to quantify pelvic reduction due to the PCCD in comparison to the quality of reduction after definitive stabilization. Results were stratified into external rotation and internal rotation fracture patterns.
  
  
  RESULTS
  In the external rotation group, the PCCD significantly reduced the pelvic width by 9.9 +/- 6.0%. This reduction closely approximated the 10.0 +/- 4.1% reduction in pelvic width achieved by definitive stabilization. In the internal rotation group, the PCCD did not cause significant overcompression. No complications were observed.
  
  
  CONCLUSIONS
  A PCCD can effectively reduce pelvic ring injuries. It poses a minimal risk for overcompression and complications as compared with reduction alternatives that do not provide a feedback on the applied reduction force.
authors.affiliation: Biomechanics Laboratory, Legacy Health System, Portland, OR 97232, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Krieg
authors.forename: Marcus
authors.initials: M
authors.lastname: Mohr
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ellis
authors.forename: Tamara S
authors.initials: TS
authors.lastname: Simpson
authors.forename: Steven M
authors.initials: SM
authors.lastname: Madey
authors.forename: Michael
authors.initials: M
authors.lastname: Bottlang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004630:Emergencies; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D010384:Pelvic Bones / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome