Abstract
Objective:To assess the quality of applied pelvic binders using three dimensional computer tomography (3D CT).Methods:A local trauma registry was used to identify patients with pelvic fractures after high-energy trauma during 2011-2015. A 3D CT reconstruction was made from the initial trauma computer tomography images to assess the level of application, symmetricity of the binder and achieved fracture reduction. An acceptable application of the pelvic binder was deemed if it was at the trochanteric level, symmetric and minimized residual displacement.Results:We found 73 patients with a pelvic fracture and a pelvic binder on the initial trauma CT-scan. The mean (±SD) age of the patients was 46±17 years and 40% (n=29) were females. The median ISS score was 38 (IQR;29-50), the mean systolic blood pressure on arrival was 106±46 mmHg and the median GCS on arrival was 14 (IQR;7-15). We found that 59% (n=43) of the binders were correctly applied (symmetric at the trochanteric level, symmetrical and with acceptable residual displacement of the fracture). The 30-day mortality was higher in patients with non-correct application 17% (n=5/30) compared to patients with correct application of the pelvic binder 9.3% (n=4/43) however this was not statistically significant (p=0.562). Conclusion:A substantial number of patients had non-correct application of pelvic binders. Future studies using 3D technique are encouraged to further investigate clinical impacts of non-appropriate application of pelvic binders.
Highlights
Pelvic ring fractures are uncommon and constitute about 3-8% of all fractures, but in major trauma cases the incidence is increased to almost 20% [1]
Assessment of Pelvic Binder Application Three dimensional (3D) reconstructions of the primary trauma CT-scans using the Sectra® (Linköping, Sweden) software were made in all patients to assess the level of application, symmetricity of the PB in relationship to the pelvic ring and if there were any residual displacement of the pelvic fracture after PB application
Pelvic fractures are potentially lethal because of bleeding, and stabilization and reduction of the pelvic ring has shown to be of high importance
Summary
Pelvic ring fractures are uncommon and constitute about 3-8% of all fractures, but in major trauma cases (multiply injured patients and/or severe highenergy trauma) the incidence is increased to almost 20% [1]. These injuries often stem from high-energy blunt trauma like traffic accidents or fall from heights. Our primary aim was to assess and report the quality of PB application in Sweden’s largest trauma centre (Karolinska University Hospital, Stockholm) in patients with high-energy pelvic fractures. Our secondary aim was to assess whether proper PB application did affect the outcome for trauma patients with pelvic fracture
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