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Kendrick's extrication device and unstable pelvic fractures: Should a trochanteric belt be added? A cadaveric study.

Authors
  • Reynard, Floran A1
  • Flaris, Alexandros N2
  • Simms, Eric R3
  • Rouvière, Olivier4
  • Roy, Pascal5
  • Prat, Nicolas J6
  • Damizet, Jean-Gabriel7
  • Caillot, Jean-Louis8
  • Voiglio, Eric J9
  • 1 University of Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Laboratoire d'Anatomie, UMR T9405, F-69003 Lyon, France. , (France)
  • 2 University of Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Laboratoire d'Anatomie, UMR T9405, F-69003 Lyon, France; Hospices Civils de Lyon, Unit of Emergency Surgery, Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite, France; Protypon Neurological-Neuromuscular Center, Thessaloniki, Greece. , (France)
  • 3 Hospices Civils de Lyon, Unit of Emergency Surgery, Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite, France; Tulane University School of Medicine, New Orleans, LA, USA. , (France)
  • 4 Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, F-69437 Lyon, France. , (France)
  • 5 University of Lyon, Université Lyon 1, CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69622 Villeurbanne, France. , (France)
  • 6 Institut de Recherche Biomédicale des Armées, SMCF, F-91223 Brétigny sur Orge, France. , (France)
  • 7 Service de Santé et de Secours Médical, Service d'Incendie et de Secours du Rhône et de la Métropole de Lyon, F-69421 Lyon, France. , (France)
  • 8 Hospices Civils de Lyon, Unit of Emergency Surgery, Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite, France. , (France)
  • 9 University of Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Laboratoire d'Anatomie, UMR T9405, F-69003 Lyon, France; Hospices Civils de Lyon, Unit of Emergency Surgery, Centre Hospitalier Lyon-Sud, F-69495 Pierre-Bénite, France; Service de Santé et de Secours Médical, Service d'Incendie et de Secours du Rhône et de la Métropole de Lyon, F-69421 Lyon, France. Electronic address: [email protected] , (France)
Type
Published Article
Journal
Injury
Publication Date
Mar 01, 2016
Volume
47
Issue
3
Pages
711–716
Identifiers
DOI: 10.1016/j.injury.2016.01.028
PMID: 26867981
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Pre-hospital pelvic stabilisation is advised to prevent exsanguination in patients with unstable pelvic fractures (UPFs). Kendrick's extrication device (KED) is commonly used to extricate patients from cars or crevasses. However the KED has not been tested for potential adverse effects in patients with pelvic fractures. The aim of this study was to examine the effect of the KED on pubic symphysis diastasis (SyD) with and without the use of a trochanteric belt (TB) during the extraction process following a MVC. Left-sided "open-book" UPFs were created in 18 human cadavers that were placed in seven different positions simulating pre-extraction and extraction positions using the KED with and without a TB in two different positions (through and over the thigh straps). The SyD was measured using anteroposterior radiographs. The effects of the KED with and without TB, on the SyD, were evaluated. The KED alone resulted in a non-significant increase of the SyD compared to baseline, whereas the addition of a TB to the KED resulted in a significant reduction of the SyD (p<0.001). The TB through the straps provided a significantly better reduction than the TB over the straps in the extracted position (p<0.05). Our study demonstrated that a TB in combination with the KED on UPFs is an effective way to achieve early reduction. The addition of the TB in combination with the KED could be considered for Pre-Hospital Trauma Life Support (PHTLS) training protocols. Copyright © 2016 Elsevier Ltd. All rights reserved.

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