NDLI: False negative computed tomography scan due to pelvic binder in a patient with pelvic disruption: a case report and review of the literature

Content Provider	Springer Nature : BioMed Central
Author	Jamme, Sharon Poletti, Alexandre Gamulin, Axel Rutschmann, Olivier Andereggen, Elisabeth Grosgurin, Olivier Marti, Christophe
Abstract	Background Pelvic binders are routinely used in the prehospital setting for stabilization of pelvic injuries in patients with trauma. Emergency department trauma management relies on primary and secondary survey assessment and imaging, most often computed tomography, in hemodynamically stable patients. Maintaining the pelvic binder in situ allows stabilization of pelvic injuries during imaging but may hinder the visualization of some pelvic lesions. We report a very rare case of severe pelvic disruption with an absolutely normal computed tomography scan due to the effective placement of a pelvic binder. Case presentation We report the case of a 49-year-old Caucasian man referred to our Emergency Department after a high velocity motorcycle accident. Primary assessment revealed a left wrist deformation and pelvic pain, and a pelvic binder was applied by paramedics. A total body computed tomography scan was performed after arrival in our Emergency Department and did not reveal any pelvic injury. The pelvic binder was removed and because of persisting symphyseal pain, pelvic plain radiography was performed revealing a pelvic disruption with an opening of the pubic symphysis and of the left sacroiliac joint (“open book” type pelvic injury) requiring surgical stabilization. Conclusions Pelvic binders may mask pelvic disruption in patients with trauma. Pelvic plain radiography should be repeated after pelvic binder removal in patients with high velocity trauma and pelvic symptoms or neurological alterations limiting the reliability of clinical examination.
Related Links	https://jmedicalcasereports.biomedcentral.com/counter/pdf/10.1186/s13256-018-1808-7.pdf
Ending Page	4
Page Count	4
Starting Page	1
File Format	HTM / HTML
ISSN	17521947
DOI	10.1186/s13256-018-1808-7
Journal	Journal of Medical Case Reports
Issue Number	1
Volume Number	12
Language	English
Publisher	BioMed Central
Publisher Date	2018-09-21
Access Restriction	Open
Subject Keyword	Medicine Public Health General Practice Family Medicine Primary Care Medicine Surgical Oncology Internal Medicine Pelvic disruption Trauma Pelvic binder Medicine/Public Health
Content Type	Text
Resource Type	Case study
Subject	Medicine
Journal Impact Factor	0.9/2023

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