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Pelvic splints for all types of suspected pelvic fractures

Three Part Question

In [patients with pelvic injuries other than open book fractures] does [application of a pelvic splint] affect [survival, outcome or the incidence of adverse effects]?

Clinical Scenario

A 30-year-old man falls from a third storey window on to concrete. He complains of pain around his pelvis. You know that a vertical shear injury is more likely than an open book pelvic injury with this mechanism, and wonder whether you should apply a pelvic splint before he reaches hospital, when he arrives, or not at all.

Search Strategy

Ovid MEDLINE(R) 1950 to August Week 3 2010: ((exp Pelvic Bones/OR exp Pelvis/AND exp Fractures, Bone/) OR pelvic injur$.mp) AND exp splints/. Limit to English language and humans 15 records.

The Cochrane Library August 2010: MeSH descriptor Pelvis explode all trees AND MeSH descriptor Fractures, Bone explode all trees 4 records 0 relevant.

Search Outcome

Nineteen unique papers were found, of which none presented any evidence to answer the question.

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses

Comment(s)

The question has not been answered with any research. Only level 5 evidence (opinions of respected authorities, based on clinical evidence, descriptive studies or reports of expert consensus committees) was available.

Clinical Bottom Line

There is no evidence to answer the question posed. Local advice should be followed

References

  1. Lee C, Porter K. The Pre-Hospital Management of Pelvic Fractures. Emerg Med J 2007;24:1303.
  2. Melamed E, Blumenfeld A, Kalmovich B et al. Prehospital Care of Orthopedic Injuries. Prehosp Disaster Med 2007;22:225.
  3. Geeraerts T, Chhor V, Cheisson G, et al. Clinical review: initial management of blunt pelvic trauma patients with haemodynamic instability. Crit Care 2007;11:204.