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Background: Severe hemorrhage is a dreaded complication of pelvic fractures. It has a significant impact on early trauma-associated mortality. Hemorrhage that is secondary to pelvic fractures can be reduced by external stabilization devices. Despite the commercial availability of many different systems, they are infrequently used. The aim of this computed tomography (CT) study was to examine the use of external pelvic stabilization devices., Methods: Between 1 January 2011 and 31 December 2015 a total of 982 images produced in CT trauma scans at a level 1 trauma centre were retrospectively examined with respect to the presence of external pelvic stabilizers. The type of device applied, its actual position including deviation from optimal position as well as pelvic parameters and complications were determined., Results: In 67 out of 982 patients (6.82%) with suspected multiple trauma, an external pelvic stabilizer was employed. In 41.8% the devices were not placed in concordance with prevailing scientific knowledge, 53.73% of devices did not comply with the manufacturer's instructions and 51.85% of systems with pneumatic cuffs caused significant malrotation. In one patient the cuff induced hypoperfusion of the leg but without further sequelae., Conclusion: While the prehospital use of pelvic slings is increasing, misplacement is very common. Especially inconsistencies between manufacturers' manuals and current scientific knowledge warrant further improvement. In systems with pneumatic cuffs malrotation of the device is common and clinically relevant. Hypoperfusion of the lower extremities is possible and should be taken into account when employing these devices.

Purpose: Purpose of this paper is to evaluate the primary stability of a new approach for facet fixation the so-called Facet Wedge (FW) in comparison with established posterior fixation techniques like pedicle screws (PS) and translaminar facet screws (TLS) with and without anterior cage interposition., Methods: Twenty-four monosegmental fresh frozen non-osteoporotic human motion segments (L2-L3 and L4-L5) were tested in a two-arm biomechanical study using a robot-based spine tester. Facet Wedge was compared with pedicle screws and translaminar screws as a stand-alone device and in combination with an anterior fusion cage., Results: Pedicle screws, FW and translaminar screws could stabilize an intact motion segment effectively. Facet Wedge was comparable to PS for lateral bending, extension and flexion and slightly superior for axial rotation. Facet Wedge showed a superior kinematic capacity compared to translaminar screws., Conclusions: Facet Wedge offers a novel posterior approach in achieving primary stability in lumbar spinal fixation. The results of the present study showed that the Facet Wedge has a comparable primary stability to pedicle screws and potential advantages over translaminar screws.