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

International Orthopaedics volume 37, pages 1335–1339 (2013)Cite this article

Abstract

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. Fifty-six 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.

Conclusion

There is great variability in practice amongst trauma units in the UK. Training must be formalised and provided as a mandatory part of departmental induction. The use of standardised treatment algorithms in trauma units and the Advanced Trauma and Life Support (ATLS) framework may help decision making and improve patient survival rates.

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References

  1. Gansslen A, Pohlemann T, Paul C et al (1996) Epidemiology of pelvic ring injuries. Inj Int J Care Injured 27(Suppl 1):S-A13–S-A20

    Google Scholar 

  2. Hauschild O, Strohm PC, Culemann U et al (2008) Mortality in patients with pelvic fractures: results from the German pelvic injury register. J Trauma-Inj Infect Crit Care 64(2):449–455

    Article  Google Scholar 

  3. Evans JA, van Wessem KJ, McDougall D et al (2010) Epidemiology of traumatic deaths: comprehensive population-based assessment. World J Surg 34:158–163

    PubMed  Article  Google Scholar 

  4. American College of Surgeons Committee on Trauma (2008) Advanced trauma life support, 8th edition

  5. Croce MA, Magnotti LJ, Savage SA et al (2007) Emergent pelvic fixation in patients with exsanguinating pelvic fractures. J Am Coll Surg 204:935–939

    PubMed  Article  Google Scholar 

  6. Ghaemmaghami V, Sperry J, Gunst M et al (2007) Effects of early use of external pelvic compression on transfusion requirements and mortality in pelvic fractures. Am J Surg 194:720–723

    PubMed  Article  Google Scholar 

  7. Bonner TJ, Eardley WGP, Newell N et al (2011) Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring. J Bone Joint Surg Br 93-B:1524–1528

    Article  Google Scholar 

  8. Krieg JC, Mohr M, Ellis TJ et al (2005) Emergent stabilization of pelvic ring injuries by controlled circumferential compression: a clinical trial. J Trauma 59:659–664

    PubMed  Article  Google Scholar 

  9. Qureshi A, McGee A, Cooper JP, Porter KM (2005) Reduction of the posterior pelvic ring by non-invasive stabilisation: a report of two cases. Emerg Med J 22:885–886

    PubMed  Article  CAS  Google Scholar 

  10. http://www.nhs.uk/ServiceDirectories/Pages/AcuteTrustListing.aspx

  11. Chesser TJS, Cross AM, Ward AJ (2012) The use of pelvic binders in the emergent management of potential pelvic trauma. Inj Int J Care Injured 43(6):667–669

    Article  CAS  Google Scholar 

  12. Knops SP, Van Lieshout EMM, Spanjersberg WR et al (2011) Randomised clinical trial comparing pressure characteristics of pelvic circumferential compression devices in healthy volunteers. Inj Int J Care Injured 42(10):1020–1026

    Article  Google Scholar 

  13. Nunn T, Cosker D, Pallister I (2007) Immediate application of improvised pelvic binder as first step in extended resuscitation from life-threatening hypovolaemic shock in conscious patients with unstable pelvic injuries. Inj Int J Care Injured 38:125–128

    Article  Google Scholar 

  14. Routt ML Jr, Falicov A, Woodhouse E, Schildhauer TA (2002) Circumferential pelvic antishock sheeting: a temporary resuscitation aid. J Orthop Trauma 16:45–48

    PubMed  Article  Google Scholar 

  15. DeAngelis NA, Wixted JJ, Drew J et al (2008) Use of the trauma pelvic orthotic device (T-POD) for provisional stabilisation of anterior-posterior compression type pelvic fractures: a cadaveric study. Inj Int J Care Injured 39(8):903–906

    Article  Google Scholar 

  16. Jowett AJ, Bowyer GW (2007) Pressure characteristics of pelvic binders. Inj Int J Care Injured 38:118–121

    Article  CAS  Google Scholar 

  17. Bottlang M, Simpson T, Sigg J, Krieg JC, Madey SM, Long WB (2002) Noninvasive reduction of open-book pelvic fractures by circumferential compression. J Orthop Trauma 16:367–373

    PubMed  Article  Google Scholar 

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Affiliations

  1. Department of Trauma & Orthopaedic Surgery, Scarborough General Hospital, Woodlands Drive, Scarborough, North Yorkshire, YO12 6QL, UK

    Sameer Jain, Sabri Bleibleh, Jan Marciniak & Alistair Pace

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  1. Sameer Jain
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  2. Sabri Bleibleh
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  3. Jan Marciniak
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  4. Alistair Pace
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Correspondence to Sameer Jain.

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Jain, S., Bleibleh, S., Marciniak, J. et al. A national survey of United Kingdom trauma units on the use of pelvic binders. International Orthopaedics (SICOT) 37, 1335–1339 (2013). https://doi.org/10.1007/s00264-013-1828-2

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  • DOI: https://doi.org/10.1007/s00264-013-1828-2

Keywords

  • Emergency Department
  • National Health Service
  • Great Trochanter
  • Pelvic Fracture
  • Pelvic Injury