An 'open book' pelvis (APC-II/III) is initially managed in the Emergency Department by application of a pelvic binder. The binder should be positioned at the level of:

• A The iliac crests
• B The greater trochanters (level of the symphysis pubis) ✓
• C The umbilicus
• D The ischial tuberosities

Explanation

The pelvic binder must be applied at the level of the greater trochanters (approximately the same level as the symphysis pubis), not at the iliac crests, to effectively close the pelvis by internally rotating the lower limbs and compressing the true pelvis. Placing the binder at the iliac crest level compresses the abdominal contents and does not reduce the pubic symphysis diastasis. Internal rotation of the legs prior to or after binder application augments reduction.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.