Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;47(2):493-498.
doi: 10.1007/s00068-019-01239-6. Epub 2019 Oct 14.

Is there any benefit in the pre-hospital application of pelvic binders in patients with suspected pelvic injuries?

Uwe Schweigkofler  1 , Bernd Wohlrath  2 , Heiko Trentzsch  3 , Konstantin Horas  2 , Reinhard Hoffmann  2 , Dennis Wincheringer  2
Affiliations

Is there any benefit in the pre-hospital application of pelvic binders in patients with suspected pelvic injuries?

Uwe Schweigkofler et al. Eur J Trauma Emerg Surg. 2021 Apr.

Abstract

Background: Massive hemorrhage is a common cause of death in patients sustaining instable pelvic ring fractures. Pelvic binders have been propagated for rapid, non-invasive pelvic ring stabilization and control of severe pelvic hemorrhage. There is a recommendation to applicate a pelvic binder due to the trauma mechanism alone. However, there is little evidence to support this advice. The aim of this study was to evaluate effects of an early pelvic binder application on transfusion requirements and hospital mortality.

Methods: This was a subgroup analysis of a study investigating clinical examination for pelvic stability. We included 64 patients who showed radiologically proven pelvic ring fracture (Tile type B or C). Study data were complemented by retrospective chart review to assess transfusion requirements. We used descriptive statistical analysis.

Results: 37 patients had a pelvic binder applied during prehospital treatment (pb), 27 received no binder (npb). Both showed no statistically significant difference in terms of injury severity or probability of survival. We found a trend towards higher ISS (29.7 vs. 24.4) and a lower probability of survival (RISC-II Prognosis 81% vs. 89%) in the pb group. Risk for massive transfusion according to TASH-Scores (10% vs. 6%), and average number of RPBC transfused (10.5 vs. 7.5) was higher in the pb group, without statistically significance. 20 patients (54%) in the pb group and 15 patients (55%) in the npb group showed a need of RPBC within the first 72 h. There was no significant difference in hospital mortality (20% vs. 13.3%).

Conclusion: We were unable to identify blood-saving effects with application of a pelvic binder to patients with instable pelvic ring fractures in terms of RPBC requirements. Nevertheless, some salutary effect of prehospital pb application may be assumed. Better studies are needed to elucidate the value of this intervention.

Keywords: Blunt trauma; Haemorrhage; Multiple trauma; Pelvic bleeding; Pelvic ring fracture; Prehospital emergency trauma care.

PubMed Disclaimer

References

    1. Manson T, et al. Young-Burgess classification of pelvic ring fractures: does it predict mortality, transfusion requirements, and non-orthopaedic injuries? J Orthop Trauma. 2010;24(10):603–9. - DOI
    1. Mucha P, Welch TJ. Hemorrhage in major pelvic fractures. Surg Clin N Am. 1988;68(4):757–73. - DOI
    1. Ward LD, et al. The immediate treatment of pelvic ring disruption with the pelvic stabilizer. Bull Hosp Jt Dis. 1997;56(2):104–6. - PubMed
    1. Starr AJ, et al. Pelvic ring disruptions: prediction of associated injuries, transfusion requirement, pelvic arteriography, complications, and mortality. J Orthop Trauma. 2002;16(8):553–61. - DOI
    1. Lefering R, Paffrath T. Annual_Report_TraumaRegister_DGU_2015. 2016.

LinkOut - more resources