Pelvic Trauma

Abstract

Pelvic trauma (PT) occurs in 3% of skeletal injuries, presents significant challenges in trauma care. Among severe trauma patients admitted to primary care trauma centers, 10% exhibit pelvic fractures, often resulting from high-energy mechanisms. Pelvic fractures frequently result from high-energy mechanisms, are often associated with multisystem injuries, and can lead to catastrophic bleeding. There is a risk of serious morbidity and mortality in these injuries. According to trauma registries of many countries, unstable pelvic fractures are associated with mortality rates ranging from 8 to 32%. Their severity depends on associated nonpelvic injuries and/or hemorrhagic pelvic injuries. Prehospital and hospital management of severe pelvic trauma requires clear organizational and therapeutic strategies to control bleeding as quickly as possible. Mortality rates remain high, especially in patients with hemodynamic instability, due to rapid bleeding, difficulty in achieving hemostasis and related injuries. For these reasons, a multidisciplinary approach is important in the management of resuscitation, control of bleeding, and treatment of bone injuries, especially in the first hours of trauma. Multimodal treatment approach has become the gold standard in pelvic trauma. These include prehospital use of pelvic binders, appropriate imaging strategy, and appropriate use of surgical or interventional radiological control of bleeding.