The use of pelvic binders in the emergent management of potential pelvic trauma

Chesser, T.J.S.; Cross, Alisa; Ward, A.J.

doi:10.1016/j.injury.2012.04.003

Cited by 47 publications

(30 citation statements)

References 43 publications

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“…In a recent review article, Chesser et al highlighted some controversial issues regarding the use of pelvic binders [11]. These include binder position, use in lateral compression injuries and missing diagnoses of pelvic instability on primary survey radiographs.…”

Section: Discussionmentioning

confidence: 99%

A national survey of United Kingdom trauma units on the use of pelvic binders

Jain

Bleibleh

Marciniak

et al. 2013

International Orthopaedics (SICOT)

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Purpose Major pelvic injuries resulting from high-energy trauma require emergency hospital treatment, and part of the initial management includes mechanical stabilisation of the pelvis. Controversies include binder position, use in lateral compression injuries and application during radiological assessment. We present the results of a survey of both emergency department and orthopaedic specialties. Methods A telephone survey of all 144 trauma units in the UK accepting adult pelvic trauma patients was carried out in July 2012. The duty registrar for the emergency and orthopaedic departments was contacted and asked to complete a questionnaire. Results A response rate of 100 % was achieved. Pelvic binders were available for use in approximately three quarters of the trauma units surveyed. Eight-five emergency department (59 %) and 79 orthopaedic (54.9 %) registrars had been given training on pelvic binder application. Fiftysix emergency department (38.9 %) and 114 orthopaedic (79.1 %) registrars identified the level of the greater trochanters as the most suitable position for the binder. Forty-five emergency department (31.3 %) and 58 orthopaedic (40.3 %) registrars used pelvic binders in suspected lateral compression injuries. One hundred and twenty-six emergency department (87.5 %) and 113 orthopaedic (78.5 %) registrars would not release the binder during radiological assessment of the pelvis in a haemodynamically stable patient.

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Section: Discussionmentioning

confidence: 99%

A national survey of United Kingdom trauma units on the use of pelvic binders

Jain

Bleibleh

Marciniak

et al. 2013

International Orthopaedics (SICOT)

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“…13,14 A total of 72 patients (38.5%) arrived in the emergency department with a binder in situ. It is usually not removed for imaging purposes.…”

Section: -24mentioning

confidence: 99%

“…Whilst it does not prevent plain radiographs or CT scans being undertaken, it can alter the pelvic dimensions, which may affect the ability to classify the fracture accurately. 13 The prevalence of the use of binders, and the procedures used for imaging in the presence of binders, will need to be reported in studies on patients with pelvic fractures in the future.…”

Section: -24mentioning

confidence: 99%

“…Conversely, increasing prevalence of early interventions (e. g. pre-hospital pelvic binder use) may reduce the capacity to accurately classify pelvic fractures. 13,14 Improved understanding of clinical and imaging practices for severe pelvic ring fractures is needed to inform the development of classification systems suitable for contemporary clinical practice. A focus on severe pelvic ring fractures is needed as these are the most clinically and radiologically complex patients.…”

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confidence: 99%

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The imaging and classification of severe pelvic ring fractures

Gabbe

Esser

Bucknill

et al. 2013

The Bone & Joint Journal

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We describe the routine imaging practices of Level 1 trauma centres for patients with severe pelvic ring fractures, and the interobserver reliability of the classification systems of these fractures using plain radiographs and three-dimensional (3D) CT reconstructions. Clinical and imaging data for 187 adult patients (139 men and 48 women, mean age 43 years (15 to 101)) with a severe pelvic ring fracture managed at two Level 1 trauma centres between July 2007 and June 2010 were extracted. Three experienced orthopaedic surgeons classified the plain radiographs and 3D CT reconstruction images of 100 patients using the Tile/AO and Young-Burgess systems. Reliability was compared using kappa statistics. A total of 115 patients (62%) had plain radiographs as well as two-dimensional (2D) CT and 3D CT reconstructions, 52 patients (28%) had plain films only, 12 (6.4%) had 2D and 3D CT reconstructions images only, and eight patients (4.3%) had no available images. The plain radiograph was limited to an anteroposterior pelvic view. Patients without imaging, or only plain films, were more severely injured. A total of 72 patients (39%) were imaged with a pelvic binder in situ.Interobserver Patients with severe fractures of the pelvis often have significant associated injuries and a high rate of mortality (13% to 31%).

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“…Stabilization of the pelvis in the trauma bay can be accomplished with a pelvic binder, wrapping of the pelvis with a sheet, or use of an orthopedic C-clamp [20,[27][28][29][30][31]. Although open book fractures may be reduced, patients with significant disruption of the posterior elements may have further distraction of their fractures with anterior element closure.…”

Section: Initial Evaluation and Management Of The Pelvic Fracture Patmentioning

confidence: 99%

Preperitoneal Pelvic Packing: How and When

Glass

Burlew

2014

Curr Trauma Rep

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Pelvic fractures can lead to life-threatening hemorrhage, particularly as they tend to occur in the setting of polytrauma. Several approaches to hemorrhage control have been employed in pelvic fracture patients over the years. This review describes the indications, operative technique, and outcomes for preperitoneal pelvic packing (PPP). Pelvic packing should be considered for every hemodynamically unstable patient with a significant pelvic fracture. We describe how this can be accomplished in coordination with other resuscitative efforts and operative needs.

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The use of pelvic binders in the emergent management of potential pelvic trauma

Cited by 47 publications

References 43 publications

A national survey of United Kingdom trauma units on the use of pelvic binders

A national survey of United Kingdom trauma units on the use of pelvic binders

The imaging and classification of severe pelvic ring fractures

Preperitoneal Pelvic Packing: How and When

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