Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring.
Bonner TJ, Eardley WG, Newell N, et al. The Journal of bone and joint surgery. British volume 2011 · PMID 22058306 · doi:10.1302/0301-620x.93b11.27023
- Question
- How often are pelvic binders positioned correctly, and does correct placement over the greater trochanters improve reduction of unstable pelvic injuries?
- Design
- Retrospective radiological review of pelvic radiographs taken at a single UK military hospital, with a subgroup analysis of open-book injuries.
- Patients
- Injured patients whose pelvic radiographs showed a pelvic binder with a visible buckle.
- Intervention
- Binder centred at the level of the greater trochanters
- Comparison
- Binder positioned above (or below) the greater trochanters
- Primary outcome
- Binder position relative to the trochanters, and symphyseal gap in open-book (AO/OTA 61-B/C) injuries
- Key result
- Only around half of binders sat at trochanteric level, and placement too high was the commonest error. In open-book injuries, high binders left a significantly wider symphyseal gap than correctly placed ones.
- Limitations
- Retrospective imaging study from a military population, with a small reduction subgroup and no clinical outcomes such as transfusion need or mortality.
- Impact on practice
- Reinforces teaching that the binder must be centred over the greater trochanters, not the iliac crests, and that position should be checked on the first radiograph or CT.