Pelvic Binders and Arteriography : Effect of a Pelvic Fracture Management Protocol on Mortality

title (must be complete): Use of the Trauma Pelvic Orthotic Device (T-PODTM) for Rapid Stabilization of Pelvic Fractures in the Emergency Department T.R. Bilski (1), A.J. Brooks (1), D. Scaff (1), J.P. Pryor (1), C.T. Born (2), M.K. Fitzpatrick (1), C.W. Schwab (1). (1) Division of Traumatology and Surgical Critical Care, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA, (2) Department of Orthopaedic Surgery, Temple Univeristy Hospital, Philadelphia, Pennsylvania, USA. Error in title / author line / abstract text ? Change of title / author line / text is no longer possible via the website because the program is in preparation. Please contact the congress bureau. upload / reupload additional image to this abstract ? Upload of image is no longer possible because your file has been prepared for review. Please contact the congress bureau. Send request/feedback for this abstract ? Feedback Reject abstract ? Rejecting the abstract online is no longer possible because the program is printing. Please contact the congress bureau. Reviewer's view of your abstract: Use of the Trauma Pelvic Orthotic Device (T-PODTM) for Rapid Stabilization of Pelvic Fractures in the Emergency Department Objectives: Hemodynamic compromise in patients with a rotationally unstable pelvic fracture is associated with mortality from uncontrolled hemorrhage. Essentially all algorithms for trauma resuscitation recommend bony pelvic reduction to reduce the pelvic volume. A number of techniques have been described including placement of an anterior external fixator, pelvic Cclamp or a circumferential sheet. These techniques suffer from requiring significant levels of expertise and application time or failure to assure closure of the pelvis in all body types. The Trauma Pelvic Orthotic Device (T-PODTM) is a two-piece “corset” device of sufficient length and width used to achieve rapid pelvic stability regardless of body habitus. The objective of this study was to describe our experience with the T-PODTM for the prompt bony reduction and stabilization of pelvic fractures. Material and methods: Retrospective review of the University of Pennsylvania Trauma Registry from March 2001 to December 2004 for all patients admitted with pelvic fractures initially managed with the placement of a T-PODTM in the trauma bay. Results: 484 patients with a pelvic fracture were admitted during the review period. 51 (40 male, 11 female) patients were managed with a T-PODTM that was applied in the trauma bay for hemodynamic compromise and / or pelvic instability. Injuries were sustained from motor vehicle crash (18), pedestrian vs. automobile (18), motorcycle crash (10), fall (6) and other (6). The TPODTM was applied within 15 minutes of arrival in the trauma bay in 80% of the patients. The mean injury severity score was 25 and overall mortality 25%. There was no significant difference in ISS or admission systolic blood pressure between survivors and non-survivors. Seventeen of the patients underwent emergent angiography for contrast blush on CT scan or hemodynamic instability and 13 patients underwent emergency laparotomy for abdominal injuries; 10 patients underwent both. All the procedures were performed with the T-PODTM in-situ. Conclusions: The T-PODTM is a safe and user friendly device that achieves rapid reduction of the unstable pelvis. It allows for ongoing resuscitation and angioembolization, and easy access for trauma laparotomy. Abstract status (acceptance / rejection): Congratulations ! This abstract has been accepted ! status (acceptance / rejection): Congratulations ! This abstract has been accepted ! Mode of presentation: poster only More details concerning session information will be published until end of June 2005 .