Pelvic binder explained

A pelvic binder is a device used to compress the pelvis in people with a pelvic fracture in an effort to stop bleeding.^[1]

Uses

A pelvic binder is used to reduce haemorrhage after a pelvic fracture.^[2] It is used in the majority of patients where a ring fracture to the pelvis is suspected by paramedics or physicians. A pelvic binder is recommended for open book pelvic fractures. It might not be useful in people with lateral compression pelvic fractures.^[3]

A pelvic binder can be applied by paramedic before a patient reaches hospital, or by physicians and nurses when a patient is seen in an emergency department. It should only be used short term.

Complications

Complications of a pelvic binder can include skin ulceration if it is applied for too long. Pelvic binders may be applied incorrectly in around 50% of patients.^[4]

Technique

A pelvic binder should be placed over the upper femurs, specifically the greater trochanters. This is the best position to reduce diastasis symphysis pubis.^[5] A CT scan can be used to observe the effective placement of a pelvic binder. A bed sheet may be used as part of a pelvic binder.

A pelvic binder compresses pelvic structures. This encourages any blood in the pelvic cavity to clot, reducing any further bleeding.^[6] It also stabilises the pelvis.

Notes and References

1. Book: ATLS - Advanced Trauma Life Support - Student Course Manual. 2018. American College of Surgeons. 9780996826235. 10. 96–97.
2. Naseem H, Nesbitt PD, Sprott DC, Clayson A . An assessment of pelvic binder placement at a UK major trauma centre . Annals of the Royal College of Surgeons of England . 100 . 2 . 101–105 . February 2018 . 29022794 . 5838689 . 10.1308/rcsann.2017.0159 .
3. Book: Walls R, Hockberger R, Gausche-Hill M . Rosen's Emergency Medicine - Concepts and Clinical Practice E-Book . 2017 . Elsevier Health Sciences . 978-0-323-39016-3 . 577, 588 . en.
4. Vaidya R, Roth M, Zarling B, Zhang S, Walsh C, Macsuga J, Swartz J . Application of Circumferential Compression Device (Binder) in Pelvic Injuries: Room for Improvement . The Western Journal of Emergency Medicine . 17 . 6 . 766–774 . November 2016 . 27833687 . 5102606 . 10.5811/westjem.2016.7.30057 .
5. Bonner TJ, Eardley WG, Newell N, Masouros S, Matthews JJ, Gibb I, Clasper JC . Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring . The Journal of Bone and Joint Surgery. British Volume . 93 . 11 . 1524–8 . November 2011 . 22058306 . 10.1302/0301-620X.93B11.27023 . free .
6. White CE, Hsu JR, Holcomb JB . Haemodynamically unstable pelvic fractures . Injury . 40 . 10 . 1023–30 . October 2009 . 19371871 . 10.1016/j.injury.2008.11.023 .