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Pelvic Trauma
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Pelvic binder (Figure 24.3)A pelvic binder application is done as the initial management of unstable pelvic injuries.It reduces the volume of the pelvis and creates a tamponade effect which reduces bleeding.The binder is centred over the greater trochanter of the femur.Applied as soon as the primary survey is over.Risk and complications of using a pelvic binder:Pressure sores and skin necrosis.Overcompression of the pelvis can mask pelvic injuries in radiographs.In lateral compression injuries with transforaminal sacral fractures, there is a risk of neural and visceral injury.
RLE Orthopaedic Injury Management
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Jowan Penn-Barwell, Daniel Christopher Allison
Pelvic binding represents a non-invasive variation of soft tissue traction (compression) which deserves mention in this section. In the setting of anterior-posterior pelvic injuries (pubic symphysis diastasis, bilateral pubic rami fractures) the pelvic basin or ring can actually ‘open up’ and lose its ability to apply compression to retroperitoneal vascular injury. A circumferential binder around the pelvis (in the form of a bed sheet or formal pelvic binder apparatus) applied at the level of the greater trochanters and wrapped with tension can effectively ‘close down’ this pelvic basin and allow lifesaving compression of pelvic bleeding. Given the potential for pressure sores and skin necrosis, pelvic binders placed for these injuries should normally be replaced with external fixation within 24 hours.
Catastrophic haemorrhage
Published in Ian Greaves, Keith Porter, Chris Wright, Trauma Care Pre-Hospital Manual, 2018
Ian Greaves, Keith Porter, Chris Wright
The Junctional Emergency Treatment Tool (JETT™, North American Rescue, Greer, South Carolina, United States) consists of a pelvic binder assembly with bilateral trapezoid-shaped pressure pads attached to threaded T-handles which can be used to apply pressure onto the common femoral arteries either unilaterally or bilaterally. It can be used to apply direct pressure to junctional bleeds in the groin or to gain proximal control of lower extremity bleeding. The binder assembly also serves as a pelvic binder to stabilise the pelvis. The manufacturers recommend that application time should not exceed 4 hours.
Evaluation of Pelvic Circular Compression Devices in Severely Injured Trauma Patients with Pelvic Fractures
Published in Prehospital Emergency Care, 2022
Josephine Berger-Groch, Johannes Maria Rueger, Patrick Czorlich, Karl-Heinz Frosch, Rolf Lefering, Michael Hoffmann
In contrast, a study group from Taiwan reported statistically significantly improved survival and lower mean blood transfusion volume and mortality rate in 204 patients receiving an early PCCD (30). This was a retrospective cohort study that included patients receiving the pelvic binder in the emergency department. It is possible that the application of the pelvic binder by trained ED personnel is more targeted, so that the hoped-for tamponade effect may be more visible than in a system in which many different inexperienced users apply the pelvic binder.