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52 - Severe Pelvic Trauma
from Section 11 - Trauma
- By Jeffrey Pepin
Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
Book:

Practical Emergency Resuscitation and Critical Care

Published online:

02 November 2023

Print publication:

23 November 2023, pp 561-566
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Summary

Severe pelvic fractures are a major cause of morbidity and mortality in trauma patients. As hemorrhage is the main cause of mortality in pelvic trauma, it is critical to assess hemodynamic stability and identify ongoing bleeding in the chest, abdomen and long bones. If no clear source of hemorrhage is identified and a patient remains unstable, suspicion for primary pelvic hemorrhage should be high. Suspect pelvic fracture in all cases of serious or multisystem trauma patients.
In pelvic trauma, there is a high incidence of associated injuries; therefore, special attention should be paid to the rectal and urogenital examinations. The most commonly used classification system for pelvic fractures is the Young–Burgess system. This system categorizes injuries on the basis of mechanism of injury and can be used to predict the risk of blood loss.