Binding the pelvis

KEY POINTS

  • Binding the pelvis is potentially life-saving and a key skill for extreme sports practitioners.
  • Suspect a pelvic fracture in all serious impacts.
  • Pelvic fractures can be associated with heavy internal bleeding.
  • Treat by tying a jacket around the base of the hips and tying the ankles together.

EXPLANATION

A broken pelvis is always possibility in a hard impact, particularly where there are also broken legs or spinal fractures. Pelvic fractures are serious as they can bleed heavily, but also internally, so the bleeding isn’t immediately obvious to see.  Binding the pelvis can be a life-saving intervention. 

The pelvis is made up of a number of rings. When it fractures, these rings can split apart, like an open book. The aim of binding the pelvis is to ‘close the book’, by bringing the rings back to together. The best solution is to use a binder designed for the purpose, however you can also improvise one in the field: tie a bandage, jacket or strap in a loop very firmly around the base of the hips/top of the thighs and also tie the legs together at the ankles. Be sure that once applied it won’t come undone until hospital. As ever, when you improvise something, try it on yourself or an uninjured person first, so you can then apply it smoothly and confidently on the casualty.

The correct position for the binder is usually a little lower than people think, about the level of the middle of the zipper on a pair of trousers. Described anatomically, it is at the level of the greater trochanter of the femur (the bumpy bit on the outside of the thigh).