Pelvic injuries

Pelvic fractures are a complex set of injuries often relating to high energy trauma. Because of their mechanism, they often present with associated injuries and have a high morbidity and mortality rate. Description is mainly based on the direction of injury using the Young and Burgess classification. Anteroposterior compression (APC) injuries have the highest risk of significant blood loss and mortality. Assessment should always be undertaken using advanced trauma and life support (ATLS) protocols alongside an experienced trauma team and any patient with a high energy injury should have a pelvic binder fitted to reduce the pelvic volume and tamponade any potential bleeding. Imaging can be undertaken in the emergency department setting using portable pelvic radiographs. CT scans help classify the injury and decide on definitive management. Temporary external fixation may help control fracture related haemodynamic instability with or without pelvic packing or angioembolization as indicated. Definitive fracture fixation can be undertaken when the patient, and their other injuries, are stabilized.