Effectiveness of antishock garment in acute management of open-book injuries of pelvic fractures in hemodynamically unstable patients
Keywords:Anterior external fixator, Haemodynamic state, Open book fracture pelvis, Pelvic binder
Background: Stabilizing unstable pelvic fractures with rapidly applied pelvic binder or the garment has long been a standard practice in patients suspected to be bleeding from their pelvic injuries. External fixation is believed to provide better tamponade, by decreasing the pelvic volume and, thereby, the space for blood loss.
Methods: Prospective case control randomized study. A total of 30 patients were enrolled in this study. They were recruited from Suez Canal University hospital (Ismailia). They were categorized into two groups. They were selected by simple randomization method using the table of random number. Group I: patients were subjected to antishock garment (15 patients). Group II: patients were subjected to external pelvic fixation (15 patients).
Results: Data analysis of the 30 patients showed that symphysis pubis diastasis was decreased from (3.2 to 2.8 cm) in binder group in comparison to (3.8 to 2.2cm) in EX-FIX group with statistically significant different (p value = P = 0.04). But there were no marked difference in the degree of shock index improvement between the two groups (p-value >0.05).
Conclusions: Although EX-FIX is showing significant improvement in pelvic stability and more decreasing diastasis in comparison with binder, there was no difference in improving the haemodynamic state between both maneuvers.
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