Single training session for first time pelvic C-clamp users: Correct pin placement and frame assembly

摘要

Background: Unstable pelvic fractures with associated haemodynamic instability are major contributors of mortality and morbidity after blunt trauma. The pelvic C-clamp is one of the methods for emergency skeletal stabilization for pelvic ring injuries with posterior instability. The application of this device is taught on courses, but it is seldom used. The safety and efficiency of C-clamp application by trained first time users is unknown. We hypothesised that the pelvic C-clamp cannot be safely positioned on a training model after one training session. Methods and materials: A theoretical and a practical session on the application of the pelvic C-clamp was held within an interval of 11.2 ± 4.4. Twenty-seven participants of various levels of training were assessed on accuracy and efficacy of the application of the pelvic C-clamp was applied to a pelvic model (Pelvic Trainer?). Results: 70.4% of all participants were able to place both pins inside the safe zone, whilst 81.5% of all pins were positioned safe. 18.5% were considered to be in unsafe position. The distance to optimal target point was 9.6 ± 7.8 mm on the left (injured) hemipelvis and 8.7 ± 7.8 mm on the right (uninjured). The time needed for assembly was 99.7 ± 39.7 s, for placement it averaged at 133.9 ± 74 s. Conclusions: The majority of pins were placed into the safe zone on a training model within 4 min after one training session. 18.5% dangerous pin placement within 11 days of the training requires careful consideration (risk/benefit) in the context of a critically injured dying patient.