In the patient who arrives with a suspected pelvic ring or avulsion fracture, the pelvis should be stabilized with a binding device, wrapping tightly with a sheet at the level of the greater trochanter. This intervention improves patient comfort by preventing bony fragment movement and reducing fractures and pelvic volume (EAST 2011, Level III recommendation). Whether this results in tamponade of bleeding is still controversial. Current evidence supports that it does not seem to limit further hemorrhage in these patients (EAST 2011, Level III recommendation). External fixation devices are not well supported by the literature and are not believed to decrease volume of the pelvis or change mortality.3 In addition, external fixation is time-consuming and has been largely replaced by pelvic binding. Commercial binding devices may be used instead of a sheet; however, overall improvement in mortality has not been proven.
To continue, please log in or purchase access.