Journal of Emergencies, Trauma, and Shock
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
Users online:381   Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size   
Year : 2011  |  Volume : 4  |  Issue : 4  |  Page : 477-482

C-clamp and pelvic packing for control of hemorrhage in patients with pelvic ring disruption

1 Departments of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University, Frankfurt am Main, Germany
2 Department of Trauma Surgery, Hospital Waid, Switzerland
3 Department of Orthopaedic Surgery, University Hospital Balgrist, Switzerland
4 Department of Surgery, Hospital Zollikerberg, Zurich, Switzerland
5 Department of Orthopaedic Surgery, University of Bern, Inselspital, Bern, Switzerland

Correspondence Address:
Thomas Lustenberger
Departments of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University, Frankfurt am Main
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-2700.86632

Rights and Permissions

Background : Exsanguinating hemorrhage is the major cause of death in patients with pelvic ring disruption. Aims : The aim of this study was to document outcomes after the stabilization of pelvic ring injuries by a C-clamp and control of hemorrhage by pelvic packing. Physiological parameters were tested as prognostic factors. Setting and Design : This was a retrospective study at a level I trauma center. The study period was from January 1996 to December 2007. Materials and Methods : Fifty patients with pelvic ring disruption and hemorrhagic shock were analyzed. The pelvic rings were fixed by a C-clamp, and patients with ongoing hemorrhage underwent laparotomy and extra- and/or intra-peritoneal pelvic packing. Clinical parameters (heart rate, mean arterial pressure) and physiological parameters (lactate levels, hemoglobin, hematocrit) were documented at admission and at different time points during the initial treatment (1, 2, 3, 4, 6, 8, and 12h after admission). Results : Within 12 h of admission, 16 patients died (nonsurvivors) due to hemorrhagic shock (n=13) or head injuries (n=3). In this group, 12 patients underwent laparotomy with pelvic packing. Thirty-four patients survived the first 12 h (early survivors) after fixation by a C-clamp and additional packing in 23 patients. Four of these patients died 12.3±7.1 days later due to multiple organ failure (n=3) or severe head injury (n=1). The blood lactate level at admission was significantly higher in the group of nonsurvivors (7.2±0.8 mmol/L) compared to the early survivors (4.3±0.5 mmol/L, P<0.05). While hemoglobin values improved within the first 2 h in nonsurvivors, lactate levels continued to increase. Conclusion : Pelvic packing in addition to the C-clamp fixation effectively controls severe hemorrhage in patients with pelvic ring disruption. Early sequential measurements of blood lactate levels can be used to estimate the severity of shock and the response to the shock treatment.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded22    
    Comments [Add]    
    Cited by others 2    

Recommend this journal