An antishock pelvic C-clamp is considered for provisional posterior ring stabilization in a hemodynamically unstable patient. In which of the following fracture patterns is the C-clamp contraindicated?

• A Zone II sacral fracture extending through the foramina ✓
• B Sacroiliac joint dislocation
• C Symphyseal diastasis with intact posterior ring
• D Iliac wing fracture lateral to the SI joint

Explanation

The C-clamp compresses the hemipelvises through pins placed over the posterior ilium, closing the posterior ring. In a transforaminal sacral fracture this compression narrows the foramina and can crush nerve roots, so it is contraindicated in zone II and zone III sacral fractures. It is designed for posterior ring disruptions such as SI joint dislocations and sacral ala fractures, where compression is therapeutic rather than harmful.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.