Immediate Management of Pelvic Fractures Resulting from Blunt Trauma - A Concise Update
Journal of Surgery
Volume 3, Issue 6, December 2015, Pages: 77-82
Received: Dec. 29, 2015; Accepted: Jan. 11, 2016; Published: Jan. 25, 2016
Views 4111      Downloads 97
Seneviratne R. W., Department of Surgery, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
Kumara M. M. A. J., Department of Surgery, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
De Silva P. V., Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
Article Tools
Follow on us
Pelvic trauma is considered as a management challenge even in the best trauma centres in the world. A patient can bleed to death from injuries of this highly vascular territory. Objective of this review paper is to describe the classification of pelvic trauma and to summarize the current management process of this controversial and complex condition.
Major Trauma, Pelvic Fractures, Stabilization of Pelvis, Pelvic Slings, Pelvic Instability
To cite this article
Seneviratne R. W., Kumara M. M. A. J., De Silva P. V., Immediate Management of Pelvic Fractures Resulting from Blunt Trauma - A Concise Update, Journal of Surgery. Vol. 3, No. 6, 2015, pp. 77-82. doi: 10.11648/j.js.20150306.15
Copyright © 2015 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Management of pelvic fractures./Eckroth-Bernard K1, Davis JW. 2010 Dec; 16 (6): 582-6. doi: 10.1097/MCC.0b013e3283402869.
Acta Chir Orthop Traumatol Cech. 2012; 79 (1): 65-8./[The influence of patient age and mechanism of injury on the type of pelvic fracture: epidemiological study]. Ježek M1, Džupa V.
Hemorrhage after low-energy pelvic trauma.-Krappinger D1, Zegg M, Jeske C, El Attal R, Blauth M, Rieger M. J Trauma Acute Care Surg. 2012 Feb; 72 (2): 437-42.
Magnetic resonance imaging for the evaluation of ligamentous injury in the pelvis: a prospective case-controlled study./Gary JL1, Mulligan M, Banagan K, Sciadini MF, Nascone JW, Oʼtoole RV.- J Orthop Trauma. 2014 Jan; 28 (1): 41-7. doi: 10.1097/BOT.0b013e318299ce1b./.
The selection of diagnostic modalities in the management of pelvic fracture patients requiring transfers/Chih-Yuan Fu†, Shang-Ju Yang†, Chien-Hung Liao*, Being-Chuan Lin, Shih-Ching Kang, World Journal of Emergency Surgery 2015, 10: 33 doi: 10.1186/s13017-015-0027-4.
Diagnosis and therapy of acute hemorrhage in patients with pelvic fractures - Kos S1, Gutzeit A, Hoppe H, Liu DM, Jacob AL. Semin Musculoskelet Radiol. 2013 Sep; 17 (4): 396-406. doi: 10.1055/s-0033-1356469. Epub 2013 Oct 7.
Young-Burgess Classification of Pelvic Ring Fractures: Does It Predict Mortality, Transfusion Requirements, and Non-orthopaedic Injuries?/Manson, Theodore MD; O'Toole, Robert V MD; Whitney, Augusta MD; Duggan, Brian MD; Sciadini, Marcus MD; Nascone, Jason MD -journal of Orthopaedic Trauma: October 2010 - Volume 24 - Issue 10 - pp 603-609doi: 10.1097/BOT.0b013e3181d3cb6b.
Burgess AR, Eastridge BJ, Young JW, Ellison TS, Ellison PS Jr, Poka A, Bathon GH, Brumback RJ (1990). "Pelvic ring disruptions: effective classification system and treatment protocols". J Trauma 30 (7): 848–56. doi: 10.1097/00005373-199007000-00015. PMID 2381002.
Tile M (Jan 1988). "Pelvic ring fractures: should they be fixed?" J Bone Joint Surg Br 70 (1): 1–12. PMID 3276697.
Mattox book-Trauma, Third Edition/david v. felliciano MD, Ernest E. Moore MD, Kenneth L. Mattox MD, copy right-1996 by Appelton and Lange/ISBN 0-8385-9010-1-90000.
Hemodynamically unstable pelvic fracture management by advanced trauma life support guidelines results in high mortality.-Hou Z1, Smith WR, Strohecker KA, Bowen TR, Irgit K, Baro SM, Morgan SJ. Orthopedics. 2012 Mar 7; 35(3): e319-24. doi: 10.3928/01477447-20120222-29.
Crit Care. 2012 Aug 22; 16 (4): R163. doi: 10.1186/cc11487/Acute management and outcome of multiple trauma patients with pelvic disruptions./Burkhardt M, Nienaber U, Pizanis A, Maegele M, Culemann U, Bouillon B, Flohé S, Pohlemann T, Paffrath T; Trauma Register DGU; German Pelvic Injury Register of the Deutsche Gesellschaft für Unfallchirurgie.
World J Emerg Med. 2010; 1(2): 85–92. PMCID: PMC4129756/What are the ten new commandments in severe polytrauma management/CW Kam, CH Lai, SK Lam, FL So, CL Lau, and KH Cheung.
Damage control strategies in the management of acute injury/Stephanie A Savage T. C. Fabian/European Journal of Trauma and Emergency Surgery (Impact Factor: 0.35). 04/2014; 40(2): 143-150. DOI: 10.1007/s00068-014-0386-7.
Emerg Med Australas. 2010 Dec; 22 (6): 556-64. doi: 10.1111/j.1742-6723.2010.01355.x./Management guideline in haemodynamically unstable patients with pelvic fractures: Outcomes and challenges. Asadollahi S1, de Steiger R, Gruen R, Richardson M.
Injury. 2014 Feb; 45 (2): 374-8. doi: 10.1016/j.injury.2013.10.011. Epub 2013 Oct 18. Critical review of pelvic fractures associated with external iliac artery lesion: a series of six cases. Pascarella R1, Del Torto M2, Politano R2, Commessatti M3, Fantasia R2, Maresca A2.
Management of Bleeding Pelvic Fractures- I. Marzi, T. LustenbergerScand j surgery, 2014 Apr 15: 103 (02): 104-111.
Research Article Biomechanical Comparison of Different External Fixation Configurations for Posttraumatic Pelvic Ring Instability/Simon Tiziani, 1 Georg Osterhoff, 1 StephenJ. Ferguson, 2 Gregor Spreiter, 2 MaxJ. Scheyerer, 1 Gian-Leza Spinas, 1 GuidoA. Wanner, 1 Hans-Peter Simmen, 1 and Clément M. L. Werner1 1 Department of Surgery, Division of Trauma Surgery, University Hospital Zurich, Raemistrasse100, 8091Zurich, Switzerland/Hindawi Publishing Corporation Advances in Orthopedic Surgery Volume 2014, Article ID 360165, 5 pages
METHODS AND TECHNIQUES OF PERCUTANEOUS EXTERNAL FIXATION IN PELVIC FRACTURES Pavlin Apostolov, Martin Burnev, PetarMilkov Clinic of Orthopaedics and Traumatology MBAL “Saint Anna” Hospital - Varna, Bulgaria-DOI: 10.5272/jimab.2011171.166.
Efficacy and safety of emergency non-invasive pelvic ring stabilisation-Laszlo Toth, Kate L. King, Benjamin McGrath, Zsolt J. Balogh, Volume 43, Issue 8, August 2012, Pages 1330–1334 doi: 10.1016/j.injury.2012.05.014.
Use of an improvised pneumatic anti-shock garment and a non-pneumatic anti-shock garment to control pelvic blood flow. Hauswald M, Williamson MR, Baty GM, Kerr NL, Edgar-Mied VL. Int J Emerg Med. 2010 Jul 21; 3 (3): 173-5. doi: 10.1007/s12245-010-0191-y.
The subcristal pelvic external fixator: technique, results, and rationale. Solomon LB1, Pohl AP, Sukthankar A, Chehade MJ. -J Orthop Trauma. 2009 May-Jun; 23 (5): 365-9. doi: 10.1097/BOT.0b013e3181a2aec3.
Surgical Science, 2013, 4, 225-230 Published Online April 2013 ( Treatment of Vertically Unstable Sacral Fractures with Pelvic External Fixation and Skeletal Traction-Xueyuan Wu1*, Hongbin Zhu2, Heng Du1*, Wei Ma1#, Chihua Guo1 1Department of Orthopaedics, The First Affiliated Hospital, Medical School, Xi’an Jiaotong University, Xi’an, China.
Clin Orthop Relat Res. 1991 Jun; (267): 71-8. The antishock pelvic clamp. Ganz R1, Krushell RJ, Jakob RP, Küffer J.
Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference. Stefano Magnone et al. World Journal of Emergency Surgery 2014, 9: 18 doi: 10.1186/1749-7922-9-18.
Management strategy of vascular injuries associated with pelvic fractures Klein SR1, Saroyan RM, Baumgartner F, Bongard FS. Cardiovasc Surg (Torino). 1992 May-Jun; 33 (3): 349-57.
Spiral computed tomography in the assessment of vascular lesions of the pelvis due to blunt trauma]./Romano L1, Pinto A, De Lutio Di Castelguidone E, Scaglione M, Giovine S, Sacco M, Pinto F./ J Radiol Med. 2000 Jul-Aug; 100(1-2): 29-32.
Clin Orthop Relat Res. 2013 Sep; 471 (9): 2906-11. doi: 10.1007/s11999-013-3119-z. Acute complications of patients with pelvic fractures after pelvic angiographic embolization. Matityahu A1, Marmor M, Elson JK, Lieber C, Rogalski G, Lin C, Belaye T, Miclau T 3rd, Kandemir U.
Angioembolization for pelvic hemorrhage control: results from the German pelvic injury register./Hauschild O1, Aghayev E, von Heyden J, Strohm PC, Culemann U, Pohlemann T, Suedkamp NP, Schmal H. J Trauma Acute Care Surg. 2012 Sep; 73(3): 679-84.
Utilization of angiography and embolization for abdominopelvic trauma: 14 years' experience at a level I trauma center./Roudsari BS1, Psoter KJ, Padia SA, Kogut MJ, Kwan SW/ AJR Am J Roentgenol. 2014 Jun; 202 (6): W580-5. doi: 10.2214/AJR.13.11216.
Are we delivering two standards of care for pelvic trauma? Availability of angioembolization after hours and on weekends increases time to therapeutic intervention./Schwartz DA1, Medina M, Cotton BA, Rahbar E, Wade CE, Cohen AM, Beeler AM, Burgess AR, J Trauma Acute Care Surg. 2014 Jan; 76(1): 134-9. doi: 10.1097/TA.0b013e3182ab0cfc. Holcomb JB.
Acute definitive internal fixation of pelvic ring fractures in polytrauma patients: a feasible option. Enninghorst N1, Toth L, King KL, McDougall D, Mackenzie S, Balogh ZJ. J Trauma. /2010 Apr; 68 (4): 935-41. doi: 10.1097/TA.0b013e3181d27b48.
Is Closed Reduction and Percutaneous Fixation of Unstable Posterior Ring Injuries as Accurate as Open Reduction and Internal Fixation? Lindsay A1, Tornetta P 3rd, Diwan A, Templeman D./ J Orthop Trauma. 2015 Aug 6.
Pohlemann T, Gansslen A, Bosch U, Tschern H: The technique of packing for control of hemorrhage in complex pelvic fractures. Tech Orthop 1994, 9: 267-270.
Ertel W, Keel M, Eid K, Platz A, Trentz O: Control of severe hemorrhage using C-clamp and pelvic packing in multiply injured patients with pelvic ring disruption. J Orthop Trauma 2001, 15: 468-474.
Cothren CC, Moore EE, Johnson JL, Moore JB: Outcomes in surgical versus medical patients with the secondary abdominal compartment syndrome., Am J Surg 2007, 194 (6): 804-807.
Bilateral internal iliac artery ligation as a damage control approach in massive retroperitoneal bleeding after pelvic fracture./DuBose J1, Inaba K, Barmparas G, Teixeira PG, Schnüriger B, Talving P, Salim A, Demetriades D. J Trauma. 2010 Dec; 69 (6): 1507-14. doi: 10.1097/TA.0b013e3181d74c2f.
Abrasaarrts, Orthop Traumatol Surg Res. 2013 Apr; 99(2): 175-82. doi: 10.1016/j.otsr.2012.12.014. Epub 2013 Feb 23.Unstable pelvic ring injury with hemodynamic instability: what seems the best procedure choice and sequence in the initial management? Abrassart S1, Stern R, Peter R.
Berlew cc- J Am Coll Surg. 2011 Apr; 212 (4): 628-35; discussion 635-7. doi: 10.1016/j.jamcollsurg.2010.12.020/Preperitoneal pelvic packing/external fixation with secondary angioembolization: optimal care for life-threatening hemorrhage from unstable pelvic fractures./Burlew CC1, Moore EE, Smith WR, Johnson JL, Biffl WL, Barnett CC, Stahel PF.
J Orthop Trauma. 2015 Sep 3. [Epub ahead of print]Improved Survival After Pelvic Fracture: 13 Year Experience at a Single Trauma Center Using a Multi-disciplinary Institutional Protocol. Black SR1, Sathy AK, Jo C, Wiley MR, Minei JP, Starr AJ.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186