COMBAT-TIP: Combat-Optimized Method for Bone Alignment and Tourniquet Innovation in Pelvic Fractures,A Comparative Study on Pelvic Fracture Stabilization

Abstract

Introduction

Pelvic fractures pose a significant treatment challenge in the prehospital environment, often resulting from high-energy trauma and concurrently presenting with life-threatening hemorrhage necessitating immediate intervention. Commercial pelvic binders such as the Structural Aluminum Malleable (SAM) Pelvic Sling II have become commonplace in prehospital care, especially in military medicine. However, given limitations to carried equipment and the scarcity of pelvic fractures, medics in austere conditions may opt to carry just one or even no commercial pelvic binders.

Objective

This study explored an innovative approach using 2 Combat Application Tourniquet II (CAT II) devices tandemly connected to stabilize pelvic fractures. The primary aim was to assess whether this technique will generate comparable intrapelvic pressure to the SAM Pelvic Sling II.

Methods

This study employed a human cadaveric model for which pelvic fractures were surgically created to generate an open-book fracture. Intrapelvic pressure was measured via a Foley catheter. The SAM Pelvic Sling II was applied in standard fashion 3 times, each with intrapelvic pressure recorded. Similarly, 2 CAT IIs were applied in tandem to the pelvis 3 times to generate 3 pressure measurements.

Results

There was a small yet statistically significant increase in intrapelvic pressure generated by the CAT II method than by the traditional method.

Conclusion

The use of 2 CAT II devices connected in the fashion described in this study appears to offer a potentially feasible and effective alternative for stabilizing pelvic fractures. Yet, further investigation is required before this concept is ever applied to real patients.