The measurement of the effect of knee binding on patients with symphyseal separation

Abstract Knee binding enhances pelvic reduction in patients with unstable pelvic fractures. The aim of this study was to measure the effect of knee binding on patients with certain pelvic fractures. 13 consecutive patients who underwent open reduction and internal fixation of pubic symphysis diastasis ± sacroiliac joint fixation were recruited prospectively. These patients were transferred to this National level 1 trauma centre for definitive pelvic fracture management in an elective setting. All patients had sustained anteroposterior compression type pelvic injuries. In theatre, a centred anteroposterior radiograph of the pelvis was taken both with and without binding of the knees. Measurements of symphysis pubis widening were made of the digital images taken in theatre. With knee binding, the average percentage closure of the pubic symphysis as compared to the pre-operative, pre-reduction, position was 50%. When compared to the anatomically reduced position after internal fixation, there was a 69% closure of the symphysis pubis, with knee binding. This manoeuvre is rarely employed in patients in the field but is useful both as a simple resuscitation type tool and during definitive reconstruction in the operating theatre. Just over two-thirds of the reduction can be achieved prior to commencement of the operation.