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The pelvic belt: a cautionary tale of
pressure necrosis
Prehospital emergency care for suspected pelvic injuries involves
the use of a pelvic belt. The pressure exerted by the belt will
cause necrosis of the soft tissues after a short period of time (see
figure 1).
1
If the area of pressure necrosis involves the ‘operative
field’then open reduction and internal fixation will not be
possible due to the increased risk of infection. As a consequence,
the patient may develop a pelvic mal-union, which is associated
with a poor outcome, disabling symptoms and has major
socioeconomic implications. Therefore, the need for the pelvic
belt should be reviewed as soon as possible. The absolute indi-
cation for a pelvic belt is an unstable patient with an unstable
pelvic injury. In this scenario the pelvic belt should be exchanged
for more definitive stabilisation, usually with an external fixator.
Once stable all patients with pelvic injuries should be discussed
with the local pelvic unit regarding further management.
Simon Ball, Nirav K Patel, Angus Lewis
Department of Trauma and Orthopaedic Surgery, Charing Cross Hospital, Imperial
College Healthcare NHS Trust, London, UK
Correspondence to Dr Simon Ball, 26 Albert Road, Teddington, Middlesex, London
TW11 0BD, UK; si_ball@hotmail.com
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; not externally peer reviewed.
Accepted 22 July 2010
Emerg Med J 2010;-:1. doi:10.1136/emj.2010.102160
REFERENCE
1. Knops SP, van Reil MP, Goossens RH, et al. Measurements of the exerted pressure
by pelvic circumferential compression devices. Open Orthop J 2010;17:101e6.
Figure 1 Pressure necrosis caused by a pelvic belt.
Ball S, Patel NK, Lewis A. Emerg Med J (2010). doi:10.1136/emj.2010.102160 1of1
Images in emergency medicine
EMJ Online First, published on March 25, 2011 as 10.1136/emj.2010.102160
Copyright Article author (or their employer) 2011. Produced by BMJ Publishing Group Ltd under licence.
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doi: 10.1136/emj.2010.102160
published online March 25, 2011Emerg Med J
Simon Ball, Nirav K Patel and Angus Lewis
necrosis
The pelvic belt: a cautionary tale of pressure
http://emj.bmj.com/content/early/2011/03/24/emj.2010.102160.full.html
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