常见的用于股动脉入路的骨盆固定带改良可能会妨碍固定带的效果。
Commonly performed pelvic binder modifications for femoral access may hinder binder efficacy.
作者信息
Chavez Marin A, Weinberg Jordan A, Jacobs Jordan V, Soe-Lin Hahn, Chapple Kristina M, Ryder Madison, Conley Ian, Bogert James N
机构信息
St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd. Phoenix, Arizona, 85013, United States.
Ira A. Fulton School of Engineering at Arizona State University, 699 S. Mill Ave. Tempe, Arizona, 85281, United States.
出版信息
Am J Surg. 2022 Dec;224(6):1464-1467. doi: 10.1016/j.amjsurg.2022.04.032. Epub 2022 Apr 27.
BACKGROUND
Pelvic fractures are common and potentially life-threatening. Pelvic circumferential compression devices (PCCD) can temporize hemorrhage, but more invasive strategies that involve femoral access may be necessary for definitive treatment. The aim of our study was to evaluate the efficacy of PCCDs reducing open book pelvic fractures when utilizing commonly described modifications and placement adjustments that allow for access to the femoral vasculature.
METHODS
Open book pelvic fractures were created in adult cadavers. Three commercially available PCCDs were used to reduce fractures. The binders were properly placed, moved caudally, or moved cranially and modified. Fracture reduction rates were then recorded.
RESULTS
The pelvic fracture was completely reduced with every PCCD tested when properly placed. Reduction rates decreased with improper placement and modifications.
CONCLUSION
Modifying PCCD placement to allow femoral access decreased the effectiveness of these devices Clinicians should be aware of this possibility when caring for critically injured trauma patients with pelvic fractures.
背景
骨盆骨折很常见，且可能危及生命。骨盆环压缩装置（PCCD）可暂时控制出血，但对于确定性治疗，可能需要采用涉及股动脉入路的更具侵入性的策略。我们研究的目的是评估在使用通常描述的允许进入股血管系统的改良方法和放置调整时，PCCD对开放性骨盆骨折复位的疗效。
方法
在成年尸体上制造开放性骨盆骨折。使用三种市售的PCCD来复位骨折。将固定带正确放置、向尾侧移动、向头侧移动并进行改良。然后记录骨折复位率。
结果
当正确放置时，每种测试的PCCD都能使骨盆骨折完全复位。放置不当和改良会降低复位率。
结论
修改PCCD的放置以允许股动脉入路会降低这些装置的有效性。临床医生在护理骨盆骨折的严重创伤患者时应意识到这种可能性。
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