Alba Shehu (Zurich / CH), Michel Paul Johan Teuben (Zurich / CH), Felix Karl-Ludwig Klingebiel (Zurich / CH), Yannik Kalbas (Zurich / CH), Sascha Halvachizadeh (Zurich / CH), Hans-Christoph Pape (Zurich / CH), Roman Pfeifer (Zurich / CH)
Introduction:
Iliosacral rescue screws (ISRSs) can be used in trauma patients with unstable pelvic fractures with hemodynamic instability. This study aims to evaluate the immediate effects of ISRSs on cardiopulmonary status and pelvic volume.
Methods:
Hemodynamically unstable patients with pelvic ring injuries, who received ISRS treatment between 2014 and 2022 in a level one trauma centere were included. Alterations in pelvic volume (distance between ASIS) and impact on hemodynamic status were assessed.
Results:
Forty patients (mean age:46 (±18)) with an Injury Severity Scote of 30 (±12) received were included. At trauma bay admission, patients had an average systolic blood pressure (SBP) of 85 (±16) mmHg, which rose significantly to 107 (±14) mmHg following resuscitation and ISRS placement (P=0.0003). There were no significant changes in pulse rate or the need for vasoactive medications. ISRS placement also significantly reduced pelvic volume, as the distance between the left and right ASIS decreased from 232 (±17) cm to 222 (±23) cm (P=0.015).
Conclusions:
This study shows that iliosacral rescue screws effectively reduce pelvic volume and stabilize the pelvic ring in hemodynamically unstable patients with pelvic ring injuries. Future prospective comparative studies are indicated to determine the role of ISRS in guidelines for managing unstable pelvic ring injuries
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