Kuner Valerie, van Veelen Nicole, Studer Stephanie, Van de Wall Bryan, Fornaro Jürgen, Stickel Michael, Knobe Matthias, Babst Reto, Beeres Frank J P, Link Björn-Christian
Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, 6000 Luzern, Switzerland.
Medical Faculty, University of Zurich, 8091 Zurich, Switzerland.
J Clin Med. 2021 Mar 21;10(6):1297. doi: 10.3390/jcm10061297.
Early administration of a pelvic circumferential compression device (PCCD) is recommended for suspected pelvic trauma. This study was conducted to evaluate the prevalence of PCCD in patients with pelvic fractures assigned to the resuscitation room (RR) of a Level I trauma center. Furthermore, correct application of the PCCD as well as associated injuries with potential clinical sequelae were assessed. All patients with pelvic fractures assigned to the RR of a level one trauma center between 2016 and 2017 were evaluated retrospectively. Presence and position of the PCCD on the initial trauma scan were assessed and rated. Associated injuries with potential adverse effects on clinical outcome were analysed. Seventy-seven patients were included, of which 26 (34%) had a PCCD in place. Eighteen (23%) patients had an unstable fracture pattern of whom ten (56%) had received a PCCD. The PCCD was correctly placed in four (15%) cases, acceptable in 12 (46%) and incorrectly in ten (39%). Of all patients with pelvic fractures ( = 77, 100%) treated in the RR, only one third ( = 26, 34%) had a PCCD. In addition, 39% of PCCDs were positioned incorrectly. Of the patients with unstable pelvic fractures ( = 18, 100%), more than half either did not receive any PCCD ( = 8, 44%) or had one which was inadequately positioned ( = 2, 11 %). These results underline that preclinical and clinical education programs on PCCD indication and application should be critically reassessed.
对于疑似骨盆创伤患者，建议尽早使用骨盆环形压迫装置（PCCD）。本研究旨在评估在一级创伤中心复苏室（RR）接受治疗的骨盆骨折患者中PCCD的使用情况。此外，还评估了PCCD的正确应用以及与之相关的可能产生临床后遗症的损伤情况。对2016年至2017年间在一级创伤中心RR接受治疗的所有骨盆骨折患者进行了回顾性评估。评估并分级了初次创伤扫描时PCCD的存在情况和位置。分析了对临床结局可能产生不良影响的相关损伤。纳入了77例患者，其中26例（34%）使用了PCCD。18例（23%）患者存在不稳定骨折类型，其中10例（56%）接受了PCCD。PCCD放置正确的有4例（15%），可接受的有12例（46%），放置错误的有10例（39%）。在RR接受治疗的所有骨盆骨折患者（n = 77，100%）中，只有三分之一（n = 26，34%）使用了PCCD。此外，39%的PCCD放置错误。在不稳定骨盆骨折患者（n = 18，100%）中，超过一半的患者要么未接受任何PCCD（n = 8，44%），要么接受了放置不当的PCCD（n = 2，11%）。这些结果强调，应严格重新评估关于PCCD适应症和应用的临床前和临床教育项目。
