Pelvic binding an effective, safe treatment for patients presenting with shock and high-energy pelvic fractures
Adherence to state and institutional guidelines for urgent, non-invasive pelvic ring stabilization in patients presenting with hemorrhagic shock was not found to be associated with any hazards, according to this study by researchers in Australia.
The authors noted further education and system development would aid guideline adherence.
Using a prospective pelvic fracture database at a level 1 trauma center, the researchers performed a 41-month retrospective analysis that included high-energy pelvic fractures and excluded A-type injuries and patients who were dead on arrival. Data included patient demographics, injury severity score, fracture classification, application and timing of pelvic binding, associated injuries, physiological parameters, resuscitation fluids and outcomes, according to the study abstract.
The authors also investigated pre- and post-pelvic binding radiographs, with pelvic bindings impact on soft tissue complications determined by independent investigators.
The researchers identified 115 patients with high-energy B- and C-type pelvic ring injuries, with 36 (31%) presenting with hemorrhagic shock upon arrival. Forty-three pelvic bindings were performed, according to the abstract, with 18 performed on shocked patients. The authors reported a rate of adherence to guidelines for these procedures of 50% overall (80% for B1 fracture type, 20% for B2, 20% for B3, 66% for C1, 86% for C2 and 33% for C3).
Sixty-eight percent of post-pelvic binding radiographs revealed improved or perfect pelvic alignment, with 21% of the radiographs displaying no change. Deformity occurred after application in 11% of B2- and B3-type injuries, the researchers noted.
Although in some lateral compression fracture patterns the deformity increased, no hazards were associated with the use of [pelvic binding], the authors wrote.