The pelvic C-clamp. Emergency treatment of (hemodynamically) unstable pelvic fractures

Hemodynamic instability of a pelvic fracture is the result of trauma-related destruction of the intrapelvic compartments, hemorrhage mainly from the intrapelvic venous plexus (80-90%) and, less frequently, of intrapelvic vessels (18-27%) and fracture surface. Since self-tamponade does not occur in the pelvis, the patient will bleed to death if untreated. Life-threatening pelvic injury is often accompanied by other life-threatening lesions. If this is the case, treatment according to the guidelines set out by the Germany Society of Accident Surgery in phase B of the polytrauma treatment algorithm should be applied as promptly as possible. The aim should be to stabilize the bony pelvis at the posterior pelvic ring and minimize intrapelvic volume. The pelvic C-clamp is the ideal instrument to achieve this in unstable injuries since it can be applied to both the posterior and anterior pelvic ring. It can also be integrated without problem in shock-room management. However, it is completely contraindicated in transiliac/luxation fractures and partially contraindicated in sacral burst fractures and highgrade osteoporosis.