Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study
Abstract Background Type C pelvic fractures (AO/OTA) are severe injuries that frequently lead to bleeding and hemodynamic instability. Pelvic binders play a crucial role in their initial management. Placement at the correct level in the prehospital setting is challenging. The aim of this study was t...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | International Journal of Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12245-024-00610-8 |
| _version_ | 1827328757199798272 |
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| author | Maxim Privalov Malte Junge Matthias Karl Jung Sven Yves Vetter Jochen Franke Svetlana Hetjens Paul Alfred Grützner Holger Stadthalter |
| author_facet | Maxim Privalov Malte Junge Matthias Karl Jung Sven Yves Vetter Jochen Franke Svetlana Hetjens Paul Alfred Grützner Holger Stadthalter |
| author_sort | Maxim Privalov |
| collection | DOAJ |
| description | Abstract Background Type C pelvic fractures (AO/OTA) are severe injuries that frequently lead to bleeding and hemodynamic instability. Pelvic binders play a crucial role in their initial management. Placement at the correct level in the prehospital setting is challenging. The aim of this study was to compare two pelvic binders regarding their effectiveness in reducing intrapelvic volume and increasing intrapelvic pressure in patients with type C pelvic fractures (AO/OTA) when applied at three different levels. Methods Rotationally and vertically unstable pelvic injuries (AO/OTA classification 61-C1.1) were produced in five fresh-frozen human cadaveric specimens. Intrapelvic volume, vesical pressure and compression pressure within the pubic symphysis and the sacroiliac joint were measured when applying a SAM Pelvic Sling II and a T-POD at the level of the greater trochanter as well as levels higher and lower than recommended. Results Comparison of the two pelvic binders positioned at the recommended level (greater trochanter) showed no significant difference in volume reduction (13.85 ± 31.37 cm3, p = 0.442), however, increase in vesical pressure was significantly higher when using the T-POD (5.80 ± 3.27 cmH2O, p = 0.017). When positioned at the level of the iliac crest, vesical pressure increase and intrapelvic volume reduction were significantly greater with the T-POD (14.00 ± 8.57 cmH2O, p = 0.022 and 10.45 ± 5.45 cm3, p = 0.031 respectively). Application of the SAM Pelvic Sling II below the greater trochanter led to a significantly greater decrease in volume (-32.26 ± 7.52 cm3, p = 0.003) than the T-POD. Comparison of the recommended attachment level with incorrect positioning led to no significant differences for the T-POD, while the SAM Pelvic Sling II achieved a significantly lower volume reduction when placed at the iliac crest (40.15 ± 14.57 cm3, p = 0.012) and a significantly lower increase in vesical pressure when applied below the greater trochanter (3.40 ± 1.52 cmH2O, p = 0.007). Conclusion Direct comparison of the two pelvic binders showed that the T-POD achieved significantly greater results when applied at the recommended level and was less susceptible to incorrect positioning. These outcomes support the preferred use of the T-POD for prehospital emergency pelvic stabilisation. |
| first_indexed | 2024-03-07T15:21:56Z |
| format | Article |
| id | doaj.art-6eee447e0e004fbabe67d974aeda7d07 |
| institution | Directory Open Access Journal |
| issn | 1865-1380 |
| language | English |
| last_indexed | 2024-03-07T15:21:56Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-6eee447e0e004fbabe67d974aeda7d072024-03-05T17:35:50ZengBMCInternational Journal of Emergency Medicine1865-13802024-03-0117111310.1186/s12245-024-00610-8Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric studyMaxim Privalov0Malte Junge1Matthias Karl Jung2Sven Yves Vetter3Jochen Franke4Svetlana Hetjens5Paul Alfred Grützner6Holger Stadthalter7Department for Trauma and Orthopaedic Surgery, BG Klinik LudwigshafenDepartment for Trauma and Orthopaedic Surgery, BG Klinik LudwigshafenDepartment for Trauma and Orthopaedic Surgery, BG Klinik LudwigshafenDepartment for Trauma and Orthopaedic Surgery, BG Klinik LudwigshafenDepartment for Trauma and Orthopaedic Surgery, TauernklinikumDepartment of Medical Statistics, Biomathematics and Data Processing, Universitätsklinikum MannheimDepartment for Trauma and Orthopaedic Surgery, BG Klinik LudwigshafenFriedrich-Alexander-University Erlangen-NürnbergAbstract Background Type C pelvic fractures (AO/OTA) are severe injuries that frequently lead to bleeding and hemodynamic instability. Pelvic binders play a crucial role in their initial management. Placement at the correct level in the prehospital setting is challenging. The aim of this study was to compare two pelvic binders regarding their effectiveness in reducing intrapelvic volume and increasing intrapelvic pressure in patients with type C pelvic fractures (AO/OTA) when applied at three different levels. Methods Rotationally and vertically unstable pelvic injuries (AO/OTA classification 61-C1.1) were produced in five fresh-frozen human cadaveric specimens. Intrapelvic volume, vesical pressure and compression pressure within the pubic symphysis and the sacroiliac joint were measured when applying a SAM Pelvic Sling II and a T-POD at the level of the greater trochanter as well as levels higher and lower than recommended. Results Comparison of the two pelvic binders positioned at the recommended level (greater trochanter) showed no significant difference in volume reduction (13.85 ± 31.37 cm3, p = 0.442), however, increase in vesical pressure was significantly higher when using the T-POD (5.80 ± 3.27 cmH2O, p = 0.017). When positioned at the level of the iliac crest, vesical pressure increase and intrapelvic volume reduction were significantly greater with the T-POD (14.00 ± 8.57 cmH2O, p = 0.022 and 10.45 ± 5.45 cm3, p = 0.031 respectively). Application of the SAM Pelvic Sling II below the greater trochanter led to a significantly greater decrease in volume (-32.26 ± 7.52 cm3, p = 0.003) than the T-POD. Comparison of the recommended attachment level with incorrect positioning led to no significant differences for the T-POD, while the SAM Pelvic Sling II achieved a significantly lower volume reduction when placed at the iliac crest (40.15 ± 14.57 cm3, p = 0.012) and a significantly lower increase in vesical pressure when applied below the greater trochanter (3.40 ± 1.52 cmH2O, p = 0.007). Conclusion Direct comparison of the two pelvic binders showed that the T-POD achieved significantly greater results when applied at the recommended level and was less susceptible to incorrect positioning. These outcomes support the preferred use of the T-POD for prehospital emergency pelvic stabilisation.https://doi.org/10.1186/s12245-024-00610-8Pelvic fractureUnstable pelvic InjuryPelvic binderT-PODSAM pelvic Sling IIPelvic stabilization |
| spellingShingle | Maxim Privalov Malte Junge Matthias Karl Jung Sven Yves Vetter Jochen Franke Svetlana Hetjens Paul Alfred Grützner Holger Stadthalter Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study International Journal of Emergency Medicine Pelvic fracture Unstable pelvic Injury Pelvic binder T-POD SAM pelvic Sling II Pelvic stabilization |
| title | Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study |
| title_full | Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study |
| title_fullStr | Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study |
| title_full_unstemmed | Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study |
| title_short | Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study |
| title_sort | comparison of t pod and sam pelvic sling ii and the influence of attachment level in the initial management of unstable pelvic type c injuries a cadaveric study |
| topic | Pelvic fracture Unstable pelvic Injury Pelvic binder T-POD SAM pelvic Sling II Pelvic stabilization |
| url | https://doi.org/10.1186/s12245-024-00610-8 |
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