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Are pelvic binders an effective measure to lower mortality and decrease blood loss after high energy pelvic ring
Andreas Papaleontiou1, Andréa M Poupard2, Paul Parker1
1Trauma and Orthopaedic Department, Queen Elizabeth Hospital, Mindelsohn Way, B15 2GW, Birmingham, UK.
Summary
Early pelvic binder use in trauma patients shows no clear benefit in reducing mortality or blood loss. Current widespread use may need reevaluation due to limited evidence and lack of large randomized controlled trials.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Orthopedic Trauma
Background:
- Pelvic binders are commonly used for high-energy pelvic ring injuries.
- Evidence on their effectiveness in reducing mortality and hemorrhage is inconclusive.
Purpose of the Study:
- To investigate the effectiveness of pelvic binders in trauma patients.
- To assess impact on mortality, blood loss, pain, and complications.
Main Methods:
- Systematic review of modern era articles (January 2016 - May 2024).
- Searched two databases for studies on pelvic binder effectiveness in trauma.
- Included retrospective cohort studies, interventional studies, and RCTs.
Main Results:
- No clear superiority of early pelvic binder use was demonstrated for mortality, blood product requirements, pain, or complications.
- Overall mortality was 17.4% in binder groups vs. 15.7% in no/late binder groups.
- Blood product transfusion rates were 35.6% (binder) vs. 25% (no/late binder), with mixed results on significance.
Conclusions:
- Current evidence does not support clear superiority of early pelvic binder application.
- Limited evidence and lack of large RCTs necessitate reevaluation of widespread use.
- Further investigation into alternative or adjunct devices is recommended.
