{
  "schemaVersion": 2,
  "eyebrow": "Trauma Surgery",
  "title": "Pelvic Fracture",
  "summary": "Pelvic fracture management hinges on early mechanical stabilization, rapid identification of competing bleeding sources, and pathway selection between laparotomy, preperitoneal packing, and angioembolization. Hemodynamic instability demands simultaneous damage-control resuscitation and definitive hemorrhage control at a trauma-capable center.",
  "seoDescription": "Point-of-care management of pelvic fractures, emphasizing hemorrhage control, binder use, FAST-directed laparotomy, packing, and angioembolization.",
  "clinicalQuestion": "How should physicians stabilize, evaluate, and control hemorrhage in patients with suspected pelvic fracture?",
  "specialty": "Trauma Surgery",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "pelvic fracture",
    "pelvic hemorrhage",
    "pelvic binder",
    "preperitoneal pelvic packing",
    "pelvic angioembolization",
    "trauma resuscitation",
    "pelvic fracture urethral injury"
  ],
  "keyTakeaways": [
    "Apply a pelvic binder promptly when pelvic injury is suspected in a patient with tachycardia, hypotension, or a compatible high-energy mechanism; early splinting limits fracture motion and supports clot preservation. [10][20]",
    "In hemodynamically unstable pelvic fracture, use FAST to identify hemoperitoneum requiring exploratory laparotomy; manage suspected pelvic retroperitoneal bleeding with pelvic stabilization plus institution-specific packing and/or angiographic pathways. [2][12][23]",
    "Consider pelvic angioembolization for CT contrast extravasation regardless of hemodynamic status and for persistent hemorrhage after preperitoneal packing; repeat embolization is appropriate when bleeding continues after initial pelvic embolization. [23]",
    "For pelvic fracture urethral injury, initial urinary diversion should generally be percutaneous or open suprapubic tube placement rather than urethral instrumentation. [7]",
    "Transfer patients with pelvic fractures rapidly to a trauma center capable of urgent trauma surgery, orthopedic stabilization, interventional radiology, and critical care. [17][18]"
  ],
  "sections": [
    {
      "id": "initial-trauma-priorities",
      "eyebrow": "Immediate Management",
      "heading": "Stabilize suspected pelvic injury while determining whether the pelvis is the bleeding source",
      "intro": "Treat hemorrhage and competing injuries in parallel.",
      "paragraphs": [
        "Use an ABCDE trauma assessment and initiate resuscitation concurrently with pelvic assessment. Apply a pelvic binder early when the mechanism suggests pelvic disruption or when tachycardia or hypotension raises concern for pelvic hemorrhage. Early pelvic splinting reduces motion and helps protect clot formation. [8][10][20]",
        "A pelvic fracture is a high-risk trauma marker rather than an isolated orthopedic diagnosis. Hemodynamic instability occurs in approximately 5% to 20% of pelvic fracture patients, with reported mortality of 18% to 40% in unstable presentations; prioritize hemorrhage control, associated abdominal injury assessment, and early trauma-center resources rather than waiting for definitive fracture characterization. [2][12]",
        "Do not presume hypotension is pelvic in origin. Perform FAST during initial reassessment to identify hemoperitoneum. A positive FAST in an unstable patient directs exploratory laparotomy; when laparotomy is not indicated, proceed through the institutional pelvic hemorrhage pathway using mechanical stabilization and rapid access to pelvic packing and/or angiography. [2][12]"
      ],
      "bullets": [
        "Maintain the binder until mechanical stabilization or procedural positioning requires its removal; remove it before pelvic angiography or operative management in protocols using external fixation, and reassess after hemodynamic stabilization. [21]",
        "If the pelvis is adequately stabilized with a sheet or binder, immediate hardware fixation is not required solely for initial mechanical control. [23]",
        "Arrange rapid transport or transfer to the highest available trauma-center level when pelvic fracture is identified or strongly suspected, because urgent surgical, orthopedic, interventional radiology, and intensive-care resources may be required. [17][18]"
      ],
      "subsections": [],
      "table": {
        "caption": "Initial branch points for suspected pelvic-fracture hemorrhage. [2][12][23]",
        "columns": [
          "Clinical branch",
          "Immediate discriminator",
          "Next action"
        ],
        "rows": [
          [
            "Suspected pelvic injury with tachycardia, hypotension, or high-risk mechanism",
            "Clinical instability or mechanism compatible with pelvic disruption",
            "Apply pelvic binder during ABCDE resuscitation and activate trauma resources. [8][10][20]"
          ],
          [
            "Unstable patient with hemoperitoneum",
            "Positive FAST",
            "Proceed to exploratory laparotomy; address pelvic hemorrhage with concurrent stabilization and damage-control measures as indicated. [2][12]"
          ],
          [
            "Pelvic fracture with no laparotomy indication",
            "FAST does not direct laparotomy",
            "Use local pelvic hemorrhage pathway: stabilization with preperitoneal packing and/or pelvic angiography with embolization. [2][23]"
          ],
          [
            "Persistent pelvic bleeding after embolization",
            "Ongoing hemorrhage after prior pelvic angioembolization",
            "Repeat pelvic angioembolization. [23]"
          ]
        ]
      }
    },
    {
      "id": "imaging-and-bleeding-localization",
      "eyebrow": "Diagnostic Direction",
      "heading": "Use CT and physiologic response to select hemorrhage control",
      "intro": "Imaging should refine—not delay—the hemorrhage-control pathway.",
      "paragraphs": [
        "In a patient sufficiently stabilized for CT, obtain contrast-enhanced CT to define pelvic-ring injury, associated abdominopelvic trauma, and vascular contrast extravasation. Pelvic contrast extravasation is an indication to consider angiography and embolization even if current hemodynamics are stable. [23]",
        "Use ongoing transfusion requirement, recurrent hypotension, and failure to stabilize after binder-based reduction as evidence of continuing hemorrhage requiring escalation. Preperitoneal pelvic packing, external stabilization, angiography, and embolization are complementary modalities; the initial sequence varies by local availability and institutional protocol. [1][2][23]",
        "At angiography, selective embolization of the bleeding vessel is preferred when feasible. In severe injury or diffuse pelvic bleeding, embolization of the entire internal iliac system may be necessary. Persistent bleeding after preperitoneal pelvic packing is also an indication to consider angiographic embolization. [23]"
      ],
      "bullets": [
        "Do not use absence of hemodynamic instability to dismiss CT arterial extravasation; consider angioembolization based on the CT finding. [23]",
        "Do not delay exploratory laparotomy for pelvic angiography when FAST identifies hemoperitoneum in an unstable pelvic-fracture patient. [12]",
        "Coordinate trauma surgery, orthopedic surgery, anesthesiology, and interventional radiology early; severe pelvic hemorrhage commonly requires more than one hemostatic modality. [2][3]"
      ],
      "subsections": [
        {
          "heading": "Mechanical pattern and binder precautions",
          "paragraphs": [
            "Pelvic ring disruption on radiography or CT identifies mechanical instability and supports urgent volume reduction with binder or external fixation. Complete disruption patterns include iliosacral fracture or fracture-dislocation, pubic symphysis diastasis, and sacral fracture. [21]",
            "Avoid assuming that binder compression is harmless in every pattern. One trauma-center protocol withheld binder use in lateral-compression injuries because of concern for additional injury; therefore, maintain early stabilization while obtaining orthopedic trauma input once the fracture pattern is defined. [21]"
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Hemorrhage-control tools in pelvic fracture. [1][2][3][23]",
        "columns": [
          "Modality",
          "Best-supported role",
          "Escalation or limitation"
        ],
        "rows": [
          [
            "Pelvic binder or sheet",
            "Immediate reduction of pelvic volume and fracture motion during early resuscitation. [10][20][23]",
            "Temporary measure; remove or modify for operative or angiographic access and reassess once stable. [21]"
          ],
          [
            "External fixation",
            "Mechanical stabilization used with hemostatic procedures in unstable pelvic fracture. [3]",
            "May replace ongoing binder use after placement; does not eliminate the need to address arterial or venous bleeding. [21]"
          ],
          [
            "Preperitoneal pelvic packing",
            "Damage-control hemorrhage control in unstable pelvic fracture, particularly within surgical pathways or when laparotomy is required. [1][2][22]",
            "Persistent hemorrhage after packing should prompt consideration of pelvic angioembolization. [23]"
          ],
          [
            "Angiography and embolization",
            "Control of arterial pelvic hemorrhage; consider for CT contrast extravasation regardless of hemodynamics. [23]",
            "Repeat if hemorrhage continues; diffuse injury may require internal iliac rather than selective embolization. [23]"
          ]
        ]
      }
    },
    {
      "id": "operative-and-damage-control-strategy",
      "eyebrow": "Hemorrhage Control",
      "heading": "Choose packing, laparotomy, and angioembolization by anatomy and response",
      "intro": "The operative decision is driven by competing abdominal and pelvic bleeding priorities.",
      "paragraphs": [
        "For unstable patients with a positive FAST, exploratory laparotomy takes priority because intraperitoneal hemorrhage requires direct abdominal control. When pelvic hemorrhage remains likely, add pelvic stabilization and consider preperitoneal packing during the damage-control operation rather than relying on angiography as the first procedural step. [2][12]",
        "For an unstable patient without a laparotomy indication, rapidly select the locally available definitive pelvic hemorrhage pathway. Contemporary protocols use external stabilization with preperitoneal pelvic packing, pelvic angiography with embolization, or a staged combination; some centers add resuscitative endovascular balloon occlusion of the aorta in selected profoundly hemorrhagic patients. [1][2][3]",
        "Do not frame packing and embolization as mutually exclusive. Packing addresses pelvic bleeding rapidly in operative damage-control pathways, whereas angioembolization identifies and treats arterial bleeding and remains appropriate for CT extravasation, persistent bleeding after packing, or recurrent hemorrhage after prior embolization. [1][2][23]"
      ],
      "bullets": [
        "If angiography is selected, seek selective embolization first when the bleeding vessel is identifiable. [23]",
        "Use nonselective internal iliac embolization when injury severity or diffuse bleeding prevents selective treatment. [23]",
        "After initial hemostasis, reassess for ongoing shock and pursue repeat pelvic angioembolization when bleeding persists after a prior embolization procedure. [23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Procedure selection by early hemorrhage scenario. [2][12][23]",
        "columns": [
          "Scenario",
          "Preferred immediate procedural direction",
          "Role of subsequent intervention"
        ],
        "rows": [
          [
            "Unstable pelvic fracture with positive FAST",
            "Exploratory laparotomy for hemoperitoneum, with pelvic stabilization and packing as indicated. [2][12]",
            "Perform angiography and embolization if pelvic hemorrhage persists after operative control. [2][23]"
          ],
          [
            "Pelvic fracture with CT contrast extravasation",
            "Consider pelvic angiography and embolization irrespective of current hemodynamics. [23]",
            "Repeat embolization for continued hemorrhage. [23]"
          ],
          [
            "Persistent bleeding after preperitoneal packing",
            "Proceed to pelvic angiography and consider embolization. [23]",
            "Use selective embolization when feasible; use internal iliac embolization for diffuse bleeding. [23]"
          ],
          [
            "Ongoing bleeding after pelvic embolization",
            "Repeat pelvic angiography and embolization. [23]",
            "Reassess for nonpelvic bleeding and adequacy of mechanical stabilization. [2][23]"
          ]
        ]
      }
    },
    {
      "id": "associated-injuries-and-disposition",
      "eyebrow": "Associated Injury",
      "heading": "Protect the urinary tract and plan trauma-center disposition",
      "intro": "Associated visceral and genitourinary injury changes early procedural choices.",
      "paragraphs": [
        "Suspect pelvic fracture urethral injury when the injury pattern and pelvic trauma raise concern for urethral disruption. For most patients with pelvic fracture urethral injury, establish initial urinary drainage with percutaneous or open suprapubic tube placement. [7]",
        "Maintain a low threshold for multidisciplinary management because pelvic fractures are associated with abdominal, thoracic, vascular, neurologic, and genitourinary injury. In a preperitoneal packing cohort, associated chest injury and abdominopelvic injury were frequent, supporting deliberate reassessment for nonpelvic sources of shock rather than attribution of all instability to the pelvic ring. [21]",
        "Patients with pelvic fracture require rapid specialized care because internal hemorrhage and associated injuries may require resources not available at every hospital. Field-triage guidance supports transport to a trauma center, where definitive hemorrhage control and coordinated orthopedic management can occur without delay. [17][18]"
      ],
      "bullets": [
        "Use suprapubic diversion as initial management for most confirmed or strongly suspected pelvic fracture urethral injuries. [7]",
        "Reassess shock after every intervention; continued hypotension may reflect unresolved pelvic bleeding, hemoperitoneum, thoracic injury, or another major hemorrhage source. [2][12][21]",
        "Defer definitive pelvic-ring fixation until hemorrhage control and physiologic stabilization have been achieved; initial binder or external stabilization provides temporary mechanical management. [3][23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Associated-injury actions that alter early pelvic-fracture management. [7][12][17][18]",
        "columns": [
          "Concern",
          "Action",
          "Reason for urgency"
        ],
        "rows": [
          [
            "Hemoperitoneum in an unstable patient",
            "Perform FAST and proceed to exploratory laparotomy when FAST is positive. [12]",
            "Intraperitoneal bleeding requires operative control and should not wait for pelvic angiography. [12]"
          ],
          [
            "Pelvic fracture urethral injury",
            "Place a percutaneous or open suprapubic tube for initial urinary drainage in most patients. [7]",
            "Avoid making urinary drainage contingent on immediate urethral reconstruction. [7]"
          ],
          [
            "Limited local trauma resources",
            "Transfer rapidly to a trauma center. [17][18]",
            "Pelvic fracture may require urgent trauma surgery, interventional radiology, orthopedic stabilization, and critical care. [17][18]"
          ]
        ]
      }
    }
  ],
  "faq": [],
  "references": [
    {
      "number": 1,
      "title": "Management of Pelvic Fractures and Associated Trauma",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/nature-index/topics/l4/management-of-pelvic-fractures-and-associated-trauma",
      "authors": "www.nature.com",
      "host": "www.nature.com"
    },
    {
      "number": 2,
      "title": "Timely angiography and embolization is effective emergency treatment for severe post-traumatic pelvic fractures | Scientific Reports",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-025-88322-8",
      "authors": "www.nature.com",
      "host": "www.nature.com"
    },
    {
      "number": 3,
      "title": "Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures | Scientific Reports",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-022-07694-3",
      "authors": "www.nature.com",
      "host": "www.nature.com"
    },
    {
      "number": 4,
      "title": "Analysis of the effect of arterial embolization combined with ...",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-025-24691-4",
      "authors": "www.nature.com",
      "host": "www.nature.com"
    },
    {
      "number": 5,
      "title": "Pelvic Fracture Care - Oxford Academic",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/milmed/article-pdf/183/suppl_2/115/28507983/usy111.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com"
    },
    {
      "number": 6,
      "title": "American Association for the Surgery of Trauma–World ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jtrauma/_layouts/15/oaks.journals/downloadpdf.aspx?an=",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 7,
      "title": "Urotrauma Guideline 2020: AUA Guideline",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/auajuro/_layouts/15/oaks.journals/downloadpdf.aspx?an=00076734-202101000-00008",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 8,
      "title": "Introduction to pelvic injury and its acute management",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jotr/fulltext/2014/07010/introduction_to_pelvic_injury_and_its_acute.1.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 9,
      "title": "Institutional Practice Guidelines on Management of Pelvic ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jtrauma/_layouts/15/oaks.journals/downloadpdf.aspx?an=00005373-200504000-00018",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 10,
      "title": "Early management of the severely injured major... : BJA",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bja/article-pdf/113/2/234/4860797/aeu235.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com"
    },
    {
      "number": 11,
      "title": "Radiology: Imaging Trauma Patients in a Deployed Setting",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/milmed/article-pdf/183/suppl_2/60/28507942/usy063.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com"
    },
    {
      "number": 12,
      "title": "Angioembolization provides benefits in patients with concomitant unstable pelvic fracture and unstable hemodynamics - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0735675710005450",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 13,
      "title": "Clinical Guidelines for the Diagnosis and Treatment of ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/os.13755",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 14,
      "title": "Improved outcome after early fixation of acetabular fractures",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0020138399002338",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 15,
      "title": "Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0976566220304690",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 16,
      "title": "Pelvic and acetabular trauma",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1877132716301749",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 17,
      "title": "Guidelines for Field Triage of Injured Patients</FONT></B>\r\n<B><FONT COLOR=\"#0059f2\">Recommendations of the National Expert Panel on Field Triage</FONT>",
      "detail": "www.cdc.gov",
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5801a1.htm",
      "authors": "www.cdc.gov",
      "host": "www.cdc.gov"
    },
    {
      "number": 18,
      "title": "Guidelines for Field Triage of Injured Patients - CDC",
      "detail": "www.cdc.gov",
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6101a1.htm",
      "authors": "www.cdc.gov",
      "host": "www.cdc.gov"
    },
    {
      "number": 19,
      "title": "Overall Approach to Trauma in the Emergency Department ...",
      "detail": "publications.aap.org",
      "url": "https://publications.aap.org/pediatricsinreview/issue-pdf/825626",
      "authors": "publications.aap.org",
      "host": "publications.aap.org"
    },
    {
      "number": 20,
      "title": "Early management of the severely injured major trauma ...",
      "detail": "www.bjanaesthesia.org",
      "url": "https://www.bjanaesthesia.org/article/S0007-0912(17)31513-1/fulltext",
      "authors": "www.bjanaesthesia.org",
      "host": "www.bjanaesthesia.org"
    },
    {
      "number": 21,
      "title": "Preperitoneal pelvic packing in patients with hemodynamic instability due to severe pelvic fracture: early experience in a Korean trauma center - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/4712461",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 22,
      "title": "Effectiveness and postoperative wound infection of preperitoneal pelvic packing in patients with hemodynamic instability caused by pelvic fracture - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/6218082",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 23,
      "title": "ACS TQIP BEST PRACTICES GUIDELINES IN IMAGING",
      "detail": "www.facs.org",
      "url": "https://www.facs.org/media/oxdjw5zj/imaging_guidelines.pdf",
      "authors": "www.facs.org",
      "host": "www.facs.org"
    },
    {
      "number": 24,
      "title": "Western Trauma Association Critical Decisions in Trauma: Management of pelvic fracture with hemodynamic instability-2016 updates - PubMed",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pubmed/27537512",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    }
  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "Management of Pelvic Fractures and Associated Trauma",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/nature-index/topics/l4/management-of-pelvic-fractures-and-associated-trauma",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "This framework recommends immediate pelvic binder application, selective use of external fixation and preperitoneal pelvic packing as first-line haemorrhage",
      "score": 0.7272211
    },
    {
      "number": 2,
      "title": "Timely angiography and embolization is effective emergency treatment for severe post-traumatic pelvic fractures | Scientific Reports",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-025-88322-8",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "As a National Trauma Regional Medical Center, our hospital has developed a comprehensive emergency protocol for pelvic fractures (Fig. 2). On initial assessment of blunt pelvic fracture, immediate external pelvic stabilization and administration of tranexamic acid are performed, followed by a multid",
      "score": 0.6058229
    },
    {
      "number": 3,
      "title": "Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures | Scientific Reports",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-022-07694-3",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "Article \n    Google Scholar\n13. Burlew, C. C. et al. Preperitoneal pelvic packing/external fixation with secondary angioembolization: optimal care for life-threatening hemorrhage from unstable pelvic fractures. J. Am. Coll. Surg. 212(4), 628–635 (2011) (discussion 35-7).\n\n    Article \n    Google Sch",
      "score": 0.5843666
    },
    {
      "number": 4,
      "title": "Analysis of the effect of arterial embolization combined with ...",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-025-24691-4",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "Analysis of the effect of arterial embolization combined with external fixation in the treatment of unstable pelvic fracture with hemorrhagic",
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      "number": 5,
      "title": "Pelvic Fracture Care - Oxford Academic",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/milmed/article-pdf/183/suppl_2/115/28507983/usy111.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by WT Gordon · 2018 · Cited by 48 — The goal of this clinical practice guideline is to provide a brief review of guidelines to stabilize and treat pelvic frac- tures sustained in combat",
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    {
      "number": 6,
      "title": "American Association for the Surgery of Trauma–World ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jtrauma/_layouts/15/oaks.journals/downloadpdf.aspx?an=",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "by L Kobayashi · 2023 · Cited by 1 — Surgery guidelines on the diagnosis and management … pelvic fractures. Contemporary management of subclavian and axillary artery injuries—a",
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    {
      "number": 7,
      "title": "Urotrauma Guideline 2020: AUA Guideline",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/auajuro/_layouts/15/oaks.journals/downloadpdf.aspx?an=00076734-202101000-00008",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "by AF Morey · 2020 · Cited by 170 — Clinicians should perform percutaneous or open suprapubic tube (SPT) placement as preferred initial management for most pelvic fracture ure- thral injury (PFUI)",
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    {
      "number": 8,
      "title": "Introduction to pelvic injury and its acute management",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jotr/fulltext/2014/07010/introduction_to_pelvic_injury_and_its_acute.1.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "by P Saxena · 2014 · Cited by 5 — The treatment at the scene of the accident with suspected pelvic injury follows the general ATLS guidelines. Clinical survey (ABCDE: Airway, Breathing,",
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    {
      "number": 9,
      "title": "Institutional Practice Guidelines on Management of Pelvic ...",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/jtrauma/_layouts/15/oaks.journals/downloadpdf.aspx?an=00005373-200504000-00018",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "by Z Balogh · 2005 · Cited by 215 — Background: The management of pa- tients with hemodynamic instability related to pelvic fracture is a major challenge, with high morbidity and mortality.",
      "score": 0.474023
    },
    {
      "number": 10,
      "title": "Early management of the severely injured major... : BJA",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bja/article-pdf/113/2/234/4860797/aeu235.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by AL McCullough · 2014 · Cited by 77 — Early splinting of pelvic fractures reduces movement and protects clot formation. The use of pelvic binders is now routine in the pre-hospital setting,",
      "score": 0.24734189
    },
    {
      "number": 11,
      "title": "Radiology: Imaging Trauma Patients in a Deployed Setting",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/milmed/article-pdf/183/suppl_2/60/28507942/usy063.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by J Ritter · 2018 · Cited by 15 — Medical imaging plays a critical role in the rapid diagnosis, effective triage, and management of complex poly-trauma patients. pelvic stabilization.",
      "score": 0.123820715
    },
    {
      "number": 12,
      "title": "Angioembolization provides benefits in patients with concomitant unstable pelvic fracture and unstable hemodynamics - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0735675710005450",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Angioembolization provides benefits in patients with concomitant unstable pelvic fracture and unstable hemodynamics - ScienceDirect\n# Brief Report Angioembolization provides benefits in patients with concomitant unstable pelvic fracture and unstable hemodynamics. Pelvic fractures result in he",
      "score": 0.21685654
    },
    {
      "number": 13,
      "title": "Clinical Guidelines for the Diagnosis and Treatment of ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/os.13755",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "by J Zhang · 2023 · Cited by 36 — CT, bone scan and MRI should be checked for elderly patients with severe pelvic pain and immobilization, The CT scan alone can safely determine",
      "score": 0.18835418
    },
    {
      "number": 14,
      "title": "Improved outcome after early fixation of acetabular fractures",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0020138399002338",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "by BR Plaisier · 2000 · Cited by 118 — This study was done in order to evaluate the effect of the timing of fixation for acetabular and pelvic ring fractures on patient outcome.",
      "score": 0.7067782
    },
    {
      "number": 15,
      "title": "Management of pelvic injuries in hemodynamically unstable polytrauma patients – Challenges and current updates",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0976566220304690",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "damage, and the higher forces required to break the pelvic integrity predispose pelvic injuries to hemodynamic instability.5 It is estimated that, for every 3 min of hemodynamic instability, the mortality increases by 1% in pelvic fractures.6 Decision-making is crucial in managing these complex inju",
      "score": 0.6180666
    },
    {
      "number": 16,
      "title": "Pelvic and acetabular trauma",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1877132716301749",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "by EK Tissingh · 2017 · Cited by 4 — The overall mortality of pelvic fractures has been reported as 13.5%.16 Studies of acetabular fractures, with and without hip dislocations, have mainly reported",
      "score": 0.61779
    },
    {
      "number": 17,
      "title": "Guidelines for Field Triage of Injured Patients</FONT></B>\r\n<B><FONT COLOR=\"#0059f2\">Recommendations of the National Expert Panel on Field Triage</FONT>",
      "detail": "www.cdc.gov",
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5801a1.htm",
      "authors": "www.cdc.gov",
      "host": "www.cdc.gov",
      "snippet": "flail chest (7.5%), long-bone fracture (8.8%), pelvic fracture (11.5%), paralysis (7.1%), and amputation (10.1%)\n(60). In reviewing this criterion, the Panel took into consideration these high case-fatality rates, which place at risk vital\nsystems, including the cardiopulmonary, musculoskeletal, vas",
      "score": 0.45449692
    },
    {
      "number": 18,
      "title": "Guidelines for Field Triage of Injured Patients - CDC",
      "detail": "www.cdc.gov",
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6101a1.htm",
      "authors": "www.cdc.gov",
      "host": "www.cdc.gov",
      "snippet": "Patients with pelvic fractures should receive rapid and specialized care because of the possibility of internal hemorrhage and other associated injuries. The Panel discussed whether the term \"pelvic fracture\" was the most appropriate term for the Guidelines to use to aid EMS professionals in identif",
      "score": 0.4513029
    },
    {
      "number": 19,
      "title": "Overall Approach to Trauma in the Emergency Department ...",
      "detail": "publications.aap.org",
      "url": "https://publications.aap.org/pediatricsinreview/issue-pdf/825626",
      "authors": "publications.aap.org",
      "host": "publications.aap.org",
      "snippet": "A 12-year-old child sustained a nondisplaced pelvic fracture after a motor vehicle collision ... (5) Therefore, high clinical suspicion in this",
      "score": 0.3637152
    },
    {
      "number": 20,
      "title": "Early management of the severely injured major trauma ...",
      "detail": "www.bjanaesthesia.org",
      "url": "https://www.bjanaesthesia.org/article/S0007-0912(17)31513-1/fulltext",
      "authors": "www.bjanaesthesia.org",
      "host": "www.bjanaesthesia.org",
      "snippet": "by AL McCullough · 2014 · Cited by 77 — It is appropriate to apply a pelvic binder to any injured patient presenting with a tachycardia, hypotension, or mechanism of injury suggestive of a pelvic",
      "score": 0.20606238
    },
    {
      "number": 21,
      "title": "Preperitoneal pelvic packing in patients with hemodynamic instability due to severe pelvic fracture: early experience in a Korean trauma center - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/4712461",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Unstable pelvic fracture was defined as identification of pelvic ring complete disruption (iliosacral fracture or iliosacral fracture dislocation or symphysis pubis diastasis or sacral fracture) in anteroposterior (AP) radiograph of pelvis or abdomino-pelvic computed tomography (CT) scan. A pelvic b",
      "score": 0.5973971
    },
    {
      "number": 22,
      "title": "Effectiveness and postoperative wound infection of preperitoneal pelvic packing in patients with hemodynamic instability caused by pelvic fracture - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/6218082",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "hypotension (systolic blood pressure [SBP] < 90 mmHg) despite the loading of two units of packed red blood cells (RBCs) [13][14]. The exclusion criteria were as follows: 1) another injury that caused a major hemorrhage, 2) patients with cardiac arrest at the time of arrival to the trauma bay, 3) iso",
      "score": 0.4959723
    },
    {
      "number": 23,
      "title": "ACS TQIP BEST PRACTICES GUIDELINES IN IMAGING",
      "detail": "www.facs.org",
      "url": "https://www.facs.org/media/oxdjw5zj/imaging_guidelines.pdf",
      "authors": "www.facs.org",
      "host": "www.facs.org",
      "snippet": "however, the local availability of these resources must be considered. If the patient’s pelvis is adequately stabilized with a sheet or binder, hardware fixation is not immediately necessary. In addition, consider AE in all patients with pelvic fracture and contrast extravasation on CT scan, regardl",
      "score": 0.41023695
    },
    {
      "number": 24,
      "title": "Western Trauma Association Critical Decisions in Trauma: Management of pelvic fracture with hemodynamic instability-2016 updates - PubMed",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pubmed/27537512",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Title: Western Trauma Association Critical Decisions in Trauma: Management of pelvic fracture with hemodynamic instability-2016 updates - PubMed\nAn official website of the United States government. **The .gov means it’s official.**. Federal government websites often end in .gov or .mil. sharing sens",
      "score": 0.3835264
    }
  ],
  "publishedAt": "2026-08-24T17:45:16.515299+00:00",
  "updatedAt": "2026-08-24T17:45:16.515299+00:00",
  "readingMinutes": 5,
  "slug": "pelvic-fracture"
}