External Fixation to Control Hemorrhage
- External Fixators for Pelvic Frx
- see: vascular injuries in pelvic frx;
- theory is that the mobile, sharp edges of frx lead to dislodgment of clotted blood and renewed bleeding;
- open book pelvic frx (APC II and APC III) are most amenable to application of external fixation for reduction of blood loss;
- lateral compression injuries or internal rotatory injuries are typically associated with less bleeding.
- Timing for Application of Fixator:
- question is when to apply Ex Fix when exploratory laparotomy is planned for intraperitoneal hemorrhage due to pelvic frx;
- Arguements Against Emergent Application of Ex Fix:
- there is scant definative evidence to confirm reduction of blood loss after placement of Ex Fix;
- external fixation will not reduce bleeding from arterial disruption or from coagulopathy
Acute mortality associated with injuries to the pelvic ring: the role of early patient mobilization and external fixation.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Thursday, September 13, 2012 3:26 pm